Comparative Pharmacology
Head-to-head clinical analysis: DEPAKOTE versus GABAPENTIN ENACARBIL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DEPAKOTE versus GABAPENTIN ENACARBIL.
DEPAKOTE vs GABAPENTIN ENACARBIL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Increases GABA levels by inhibiting GABA transaminase and succinic semialdehyde dehydrogenase; also blocks voltage-gated sodium channels and T-type calcium channels.
Gabapentin enacarbil is a prodrug of gabapentin. It binds to the α2δ subunit of voltage-gated calcium channels, inhibiting calcium influx and reducing release of excitatory neurotransmitters such as glutamate, norepinephrine, and substance P. This modulates neuronal excitability and pain transmission.
Initial dose 750 mg/day PO in divided doses; increase by 250-500 mg/day every 3-7 days; maintenance dose 1000-2000 mg/day PO divided BID or TID; maximum 60 mg/kg/day.
Initial: 600 mg orally once daily; titrate to 600 mg three times daily; max 2400 mg/day divided three times daily.
None Documented
None Documented
Clinical Note
moderateGabapentin enacarbil + Venlafaxine
"The risk or severity of adverse effects can be increased when Gabapentin enacarbil is combined with Venlafaxine."
Clinical Note
moderateGabapentin enacarbil + Nefazodone
"The risk or severity of adverse effects can be increased when Gabapentin enacarbil is combined with Nefazodone."
Clinical Note
moderateGabapentin enacarbil + Stiripentol
"The risk or severity of adverse effects can be increased when Gabapentin enacarbil is combined with Stiripentol."
Clinical Note
moderateTerminal: 9-16 hours (mean 12 h); extended with hepatic dysfunction, co-administered enzyme inhibitors, or in elderly.
Terminal half-life of gabapentin: 5–7 hours in patients with normal renal function. Renal impairment prolongs half-life proportionally to creatinine clearance decline.
Renal: <3% as unchanged drug; >95% as metabolites (glucuronide conjugates, oxidation products). Biliary/fecal: minor, <5%.
Renal: 100% as unchanged gabapentin (prodrug is rapidly hydrolyzed to gabapentin after absorption). No biliary or fecal elimination of active drug.
Category C
Category A/B
Anticonvulsant
Anticonvulsant
Gabapentin enacarbil + Pomalidomide
"The risk or severity of adverse effects can be increased when Gabapentin enacarbil is combined with Pomalidomide."