Q: 52 year old male with Chronic Kidney Disease stage 4 is transferred from medical floor to ICU due to obtundation. There is a suspicion of an overdose of Gabapentin due to drug error on the floor. Patient required intubation for protection of the airway. CT Head reported negative. What is your next line of action?
Gabapentin should be given with caution in patients with renal insufficiency. Actually proper Cockcroft Gault formula should be applied for calculation of the dose. It should be sufficient to give 200 to 300 mg of gabapentin after 4 hours of each hemodialysis session in End-Stage Renal Disease (ESRD) patients if prescribed.
Wong MO, Eldon MA, Keane WF, et al. Disposition of gabapentin in anuric subjects on hemodialysis. J Clin Pharmacol. 1995;35(6):622-626. doi: 10.1002/j.1552-4604.1995.tb05020.x