Therapeutic drug monitoring of gabapentin: the applicability in patients with neuropathic pain

Abstract

Gabapentin is an antiepileptic drug prescribed for several neuropathic pain conditions. This study aimed to evaluate gabapentin (GAB) trough plasma concentration range and the applicability of therapeutic drug monitoring in patients with neuropathic pain. Fifty-three patients with neuropathic pain, aged 20 to 75, received gabapentin as treatment for at least 7 days. Gabapentin plasma concentration was sampled before GAB administration and quantified by liquid chromatography with a UV detector. GAB trough plasma concentration ranged between 0.40 and 11.94 µg/mL in patients with chronic neuropathic pain. No differences were observed in terms of GAB plasma concentrations between responsive and non-responsive patients. Our data suggest that the reference ranges suggested in the literature for patients with epilepsy should not be used for patients with neuropathic pain. Therapeutic drug monitoring of GAB was shown to be an important tool to assess treatment adherence.

The association between Gabapentin or Pregabalin use and the risk of dementia: an analysis of the National Health Insurance Research Database in Taiwan

“…Gabapentinoid agents are absorbed gastrointestinally via the l-amino acid transport system in the proximal small bowel ( Berry et al, 2003 ). Gabapentinoids have large inter-individual pharmacokinetic variability due to saturable absorption and variable renal function of the patients ( Yamamoto et al, 2022 ). A possible explanation for impact of age in our study could relate to older adults having more polypharmacy, higher co-morbidities, and decreased renal function, all of which interfere with the absorption of gabapentinoids.…”