Hi HwRSD,

Haven't been able to spend much time on the computer recently, but I needed to get back to you about this post, it has been worrying me.

I am worried about this information you give here (3 years???) and need to see the reference you found stating that Neurontin stays in the body differently from the PI statement.

Here is the information the PI sheet gives:
"Pharmacokinetics: Adults: Following oral administration of gabapentin, peak plasma concentrations are observed within 2 to 3 hours. Absolute bioavailability of a 300 mg dose of Neurontin capsules is approximately 59%. At doses of 300 and 400 mg, gabapentin bioavailability is unchanged following multiple dose administration. Neurontin 600 mg and 800 mg tablets are bioequivalent to two 300 mg capsules and two 400 mg capsules, respectively. The results of a single-dose, 2-way crossover, comparative bioavailability study in the fasted state comparing Neurontin 600 mg tablets and 2 ´ 300 mg Neurontin capsules are summarized in Table I.

Gabapentin elimination from plasma is best described by linear pharmacokinetics. The elimination half-life of gabapentin is independent of dose and averages 5 to 7 hours in subjects with normal renal function.

Plasma gabapentin concentrations are dose-proportional at doses of 300 to 400 mg q8h, ranging between 1 µg/mL and 10 µg/mL, but are less than dose-proportional above the clinical range (>600 mg q8h). There is no correlation between plasma levels and efficacy. Gabapentin pharmacokinetics are not affected by repeated administration, and steady-state plasma concentrations are predictable from single-dose data.

Gabapentin is not appreciably metabolized in humans, is eliminated solely by renal excretion, and can be removed from plasma by hemodialysis.

Gabapentin does not induce or inhibit hepatic mixed function oxidase enzymes responsible for drug metabolism, does not interfere with the metabolism of commonly coadministered antiepileptic drugs, and is minimally bound to plasma proteins.

Food has no effect on the rate or extent of absorption of gabapentin."

So, in fact gabapentin has a very short half-life (the amount of time it takes for half the amount of a drug in the blood to be eliminated by the body), 5 - 7 hours, and the information above says that this is not affected by how long you've been taking it. I've looked up the subject on the net and can't find anything to back up your information...could you post an URL, please? Or say where you found the information?

Also, I understood (actually I think we RSders know quite a bit about our meds!) that the main trouble surrounding Neurontin a few years ago was a scam between Pfizer, the med reps and doctors, rather than a problem with the medication itself, which is what your post implies. It was approved by drug-controlling bodies worldwide, including the FDA. If you mean that it wasn't approved specifically for RSD, *nothing* is, we can only take "off-label" drugs because there aren't any "on-label" drugs.

Sorry to be a pain, but I've been wondering about these comments, so I'd really like to see where you got the ideas. We need to be pretty sure about posting "fact" and "rumour" when it comes to meds - a totally different thing from posting one's own experiences. In fact, if you have any URLs for sites discussing how PI information differs from known facts, I'd appreciate that too.

BTW, many of us are on a lot of meds, it's true, and although it sounds like a "bad thing", RSD often goes hand in hand with other conditions, but it is a much worse thing for people to do without them....sad to say, but it's the way it goes. Many times these meds make the difference between someone being unable to function and consigned to a wheelchair, and leading some sort of fairly normal life. I can tell you that I would have a real problem working (which I have to do) without Neurontin. Lyrica (pregabelin), the "next generation" gabapentin med Pfizer developed after Neurontin, is stronger. Doesn't suit me personally, too strong.

Also, medication is becoming so much more "target-specific", rather than the generalized blanket drugging of old, that taking one targetting drug per specific problem makes much more sense....the trick for us, the patients, is to find a balance between them that works for us personally - and we all react differently.

I think one of the really useful things about this forum is that we compare our reactions to meds, both pharmaceutical and natural, as well as describing them for others, and we do try to be specific about references and warnings.

Hope your hubby is doing OK,
all the best