Anticonvulsants

These are generally recommended for neuropathic pain secondary to tumour infiltration, post-herpetic neuralgia and phantom limb pain. It is important to check the side effects before prescribing. Sedation and nausea are minimal if introduced slowly.

Especially useful for “shooting” and “electric shock-like” pain.

	Usual starting dose	Increase by	Usual effective dose
Sodium Valproate	200 mg/day	200 mg every 3d	400 – 1000 mg/day
Carbamazepine	100 mg/day	100 mg every 3d	400 – 800 mg/day
Gabapentin	300 mg/day	300 mg every 3d	900 – 3600 mg/day
Clonazepam	0.5 mg/nocte	0.5 mg every 3d	2 – 4 mg/day

Gabapentin (Neurontin™)

Available via special authority with specific restrictions.
See pharmac website http://www.pharmac.co.nz or check with the hospital pharmacist.
Currently restricted to patients who have tried and failed, or have been unable to tolerate, treatment with a tricyclic antidepressant.
Available in 100 mg, 300 mg and 400 mg capsules.
Caution in renal impairment as requires dose reduction.


Information about this Canterbury DHB document (4070):
Document Owner:	Palliative Care Service (see Who's Who)
Issue Date:	July 2009
Next Review:	July 2010
Keywords:
Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document.
Send Feedback	Email this page

Topic Code: 4070