Renal disease gabapentin

Drug interactions are infrequent with gabapentin. It does not induce hepatic metabolizing enzymes, nor do other AEDs affect its metabolism and elimination. Antacids may decrease absorption. Gabapentin dosage may need to be decreased in patients with renal disease or in the elderly. 

A patient with end-stage renal disease developed an encephalopathy a few days after taking gabapentin in usual adult doses. Gabapentin is excreted unchanged in the urine and its half-life, normally 5-9 hours, increases to up to 132 hours in anuria [114" ]. 

Susceptibility factors Renal disease Unrecognized gabapentin toxicity, mainly characterized by a significant deterioration in consciousness, occurred in a patient with acute renal impairment [123 ]. During episodes of acute renal insufficiency the dose of gabapentin should be reduced. 

In addition to treating insomnia, gabapentin has been used to treat epilepsy, anxiety disorders, and bipolar disorder. It is generally well tolerated with sedation and headaches being the only prominent side effects. Because gabapentin is excreted unchanged in urine, it does not require metabolism by the liver. It is therefore easily eliminated by elderly patients and those with liver disease, although it should be used with caution in those with poor renal (kidney) function. 

---