For clinical trials with once-daily gastroretentive gabapentin, the results, according to Dunteman, have suggested a considerably lower incidence of side effects than immediate-release gabapentin. His study found overall dizziness and somnolence with once-daily gabapentin was 10.9% and 4.5%, respectively, compared to 28% and 24% with immediate-release gabapentin, respectively. “There were fewer side effects with longer-acting gabapentin, in part, due to its sustained release over the entire day, versus the peaks and valleys associated with dosing three times per day,” said Dunteman.

Overall, it appears to be much easier for patients to take gabapentin once a day, especially elderly patients. “There was a higher rate of compliance, fewer side effects, and improved efficacy with the longer-acting dose. It is always nicer to take [medication] once per day, as the elderly have a tendency to forget,” said Dunteman.

Conclusion

According to Gupta, the once-daily gastrorententive gabapentin makes an improved difference overall in clinical practice for elderly individuals with PHN and other neuropathic pain conditions in which patients are unable to handle multiple doses in a single day.


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References:

  1. Centers for Disease Control and Prevention (CDC). Shingles (Herpes Zoster). Available at: http://www.cdc.gov/shingles/about/complications.html. Accessed: September 19, 2014.
  2. Markley HG, Dunteman ED, et al. Real-world experience with once-daily gabapentin for the treatment of postherpetic neuralgia (PHN). Clinical Journal of Pain. [Published online ahead of print September 17, 2014].
  3. Gupta A, Li S. Safety and efficacy of once-daily gastroretentive gabapentin in patients with postherpetic neuralgia aged 75 years and over. Drugs & Aging. 2013; 30 (12): 999-1008.