Reviewed by Linda Pungpravat, Compounding Pharmacist, RPH, Mixwell Compounding Pharmacy, Chino, CA.
What Is It?
A compounded liquid form of gabapentin, made to a prescriber's exact strength and flavor. It is prepared for one patient with a valid prescription.
How Gabapentin Works
Despite its name, gabapentin does not act on GABA receptors. It binds the alpha 2 delta subunit of voltage gated calcium channels, which reduces the release of excitatory neurotransmitters.
Why a Compounded Suspension?
Gabapentin is made mainly as capsules and tablets. A prescriber may order a liquid when a patient cannot swallow pills, needs a weight based dose, or needs a flavor a child or pet will accept.
The Xylitol Issue for Dogs
This is the main reason veterinarians order a compounded suspension. The Merck Veterinary Manual notes that some oral gabapentin solutions contain xylitol at 300 mg/mL, which is toxic to dogs at 100 mg/kg, so care must be taken to avoid those solutions in dogs. A compounded xylitol free liquid removes that concern.
Who Prescribes It
Neurology, pain management, primary care, geriatrics, hospice and palliative care, pediatrics, NPs, PAs, and naturopathic doctors. Veterinarians order it often for dogs and cats.
Safety Notes
Gabapentin can cause drowsiness and unsteadiness, and doses are adjusted for kidney function. It is a controlled substance in some states. The prescriber sets the dose and monitors the patient.
Quality
Mixwell compounds this suspension under USP 795, in a facility that also meets USP 800 standards. We are a nonsterile pharmacy and do not make injectables, and we deliver across California. Compounded medications are not reviewed or approved by the FDA and require a valid prescription. Information about compounded drugs must be truthful, accurate, and not misleading. No result is promised, and this is not presented as superior to commercial products. Talk with your health care professional, or your veterinarian, about your specific circumstances before taking or giving any medication.
References
- Merck Veterinary Manual. Toxicoses From Human Analgesics in Animals. Gabapentin section. https://www.merckvetmanual.com/toxicology/toxicoses-from-human-analgesics/toxicoses-from-human-analgesics-in-animals
- NIH National Library of Medicine. Gabapentin. https://www.ncbi.nlm.nih.gov/books/NBK493228/