A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

GENERIC NAME  
Gabapentin Renal Dosing

Gabapentin clearance is linearly proportional to creatinine clearance. It is not metabolized and is excreted unchanged.  The half-life is 5-7 hours in normal renal function and 52-131 hours in renal failure.  There have been reports of neurologic toxicities associated with gabapentin.  Severe asterixis and myoclonus have been reported that abated when the drug was discontinued or the dose was reduced.  

In patients with normal renal function (Clcr > 60) the maximum serum level obtain is 25 mcg/ml with the FDA approved dosing.  The chart or equation below may be used to determine the maximum dose a patient may receive to obtain a level of 25 mcg/ml at different levels of renal function.

 

Text Box: Maximum Daily Dose (mg) =       58 * Clcr + 129

 

 

 

 

 

 

 

 

 

 

Package Insert Dosing Guidelines

References:

Blum RA. Pharmacokinetics of gabapentin in subjects with various degrees of renal function,  Clin Pharmacol Ther. 1994;56:154-9

Bookwalter T.  Gabapentin-Induced Neurologic Toxicites,  Pharmacotherapy 2005;25:1817-19
Gadolinium Constrast Agents Gadolinium Review P&T

FDA Public Health Advisor 12/2006

FDA Public Health Advisory 6/2006 update 12/2006

ACR Guidance Document for Safe MR Practices: 2007

Gadodiamide-Associated Nephrogenic Systemic Fibrosis: Why Radiologists Should be Concerned, AJR 2007;586-92

Gadolinium-based MR Contrast Agents and Nephrogenic Systemic Fibrosis Radiology 3/2007

Gadolinium deposition in nephrogenic fibrosing dermopathy J AM Acad Dermatol 11/2006

Morbidity and Mortality Weekly Report 2/23/2007

Nephrogenic systemic fibrosis: a serious late adverse reaction to gadodiamide  10/2006

Nephrogenic systemic fibrosis following the administration of extracellular gadolinium based contrast agents: is the stability of the contrast agent molecule an important factor in the pathogenesis of this condition  Br J Radiology 2007; 73-76

 

0.2

ml/kg

Multihance

 

 

 

 

 

 

 

 

 

 

 

Creatinine Clearnace (ml/min)

120

110

100

90

80

70

60

50

40

30

20

10

0

Half-Life (Hours)

1.39

1.51

1.65

1.83

2.05

2.32

2.68

3.18

3.90

5.05

7.15

12.23

42.40

AUC (mg*min/ml)

56

61

67

74

83

94

109

129

158

205

290

496

1719

Fractional Dose Needed to Achieve Same AUC as patient with normal renal function

1.00

0.92

0.84

0.76

0.68

0.60

0.52

0.44

0.36

0.27

0.19

0.11

0.03

 

 
Gentamicin Autosubstitute with Tobramycin for documented or high risk of pseudomonas aeruginosa (Cystic Fibrosis, Neutropenia)

Pharmacokinetic dosing is available from the pharmacy. Pulse dosing, 5 mg/kg, is recommended for adults, unless exclusion criteria apply. The graphic tools are available for gentamicin / tobramcyin and amikacin.

Pulse Dosing Calculator for Aminoglycosides

Traditional Dosing Calculator for Aminoglycosides

Patient Monitoring Form

Aminoglycoside and Vancomycin Dosing & Monitoring Protocol

 
Generic Drug Product Equivalence  
   
   

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