Plasma disposition of gabapentin after the intragastric administration of escalating doses to adult horses

Abstract Background In humans, gabapentin an analgesic, undergoes non‐proportional pharmacokinetics which can alter efficacy. No information exists on the pharmacokinetics of dosages >20 mg/kg, escalating dosages or dose proportionality of gabapentin in horses. Hypothesis and Objectives Gabapentin exposure in plasma would not increase proportionally relative to the dose in horses receiving dosages ≥20 mg/kg. To assess the plasma pharmacokinetics of gabapentin after nasogastric administration of gabapentin at dosages of 10 to 160 mg/kg in adult horses. Animals Nine clinically healthy adult Arabian and Quarter Horses. Methods In a randomized blinded trial, gabapentin was administered by nasogastric intubation to horses at 10, 20 mg/kg (n = 3) and 60, 80, 120, 160 mg/kg (n = 6). Plasma was collected before and at regular times over 64 hours after administration of gabapentin. Gabapentin was quantified using a validated chromatographic method. Dose proportionality was estimated using a power model. Pharmacokinetic parameters were estimated using compartmental pharmacokinetic analysis. Results Plasma pharmacokinetics parameters of gabapentin were estimated after nasogastric administration at dosages of 10 to 160 mg/kg. Gabapentin plasma concentration increased with dose increments. However, the area under the concentration curve from zero to infinity and maximal plasma concentration did not increase proportionally relative to the dose in horses. Conclusions and Clinical Importance Gabapentin exposure in plasma is not proportional relative to the dose in horses receiving nasogastric dosages of 10 to 160 mg/kg.

[1]  M. Papich,et al.  The pharmacokinetics of gabapentin in cats , 2018, Journal of veterinary internal medicine.

[2]  Christopher D. Jackson,et al.  Hold the Gaba: A Case of Gabapentin-induced Hepatotoxicity , 2018, Cureus.

[3]  E. Stelow,et al.  Effects of a single preappointment dose of gabapentin on signs of stress in cats during transportation and veterinary examination. , 2017, Journal of the American Veterinary Medical Association.

[4]  M. Raouf,et al.  Rational dosing of gabapentin and pregabalin in chronic kidney disease , 2017, Journal of pain research.

[5]  F. Caldwell,et al.  Effect of PO Administered Gabapentin on Chronic Lameness in Horses , 2015 .

[6]  R. Baron,et al.  Neuropathic pain: principles of diagnosis and treatment. , 2015, Mayo Clinic proceedings.

[7]  T. L. A. Rocha,et al.  Gabapentin as an adjuvant for postoperative pain management in dogs undergoing mastectomy , 2015, The Journal of veterinary medical science.

[8]  B. Kukanich Outpatient oral analgesics in dogs and cats beyond nonsteroidal antiinflammatory drugs: an evidence-based approach. , 2013, The Veterinary clinics of North America. Small animal practice.

[9]  P. Lewczuk,et al.  Assessment of the effects of adjunctive gabapentin on postoperative pain after intervertebral disc surgery in dogs. , 2012, Veterinary anaesthesia and analgesia.

[10]  M. Safavi,et al.  Gabapentin: An update of its pharmacological properties and therapeutic use in epilepsy , 2011, Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences.

[11]  S. Bertini,et al.  Effects of α2-adrenergic drugs on small intestinal motility in the horse: an in vitro study. , 2011, Veterinary journal.

[12]  B. Kukanich,et al.  Pharmacokinetics of oral gabapentin in greyhound dogs. , 2011, Veterinary journal.

[13]  P. Moate,et al.  Pharmacokinetic profile and behavioral effects of gabapentin in the horse. , 2010, Journal of veterinary pharmacology and therapeutics.

[14]  M. Amore,et al.  Simultaneous HPLC-F analysis of three recent antiepileptic drugs in human plasma. , 2010, Journal of pharmaceutical and biomedical analysis.

[15]  B. Pypendop,et al.  Pharmacokinetics of gabapentin in cats. , 2010, American journal of veterinary research.

[16]  Xh Huang,et al.  Pharmacokinetic and Pharmacodynamic Data Analysis: Concepts and Applications , 2010 .

[17]  Q. Qian,et al.  Gabapentin toxicity in patients with chronic kidney disease: a preventable cause of morbidity. , 2010, The American journal of medicine.

[18]  A. Wagner,et al.  Clinical evaluation of perioperative administration of gabapentin as an adjunct for postoperative analgesia in dogs undergoing amputation of a forelimb. , 2010, Journal of the American Veterinary Medical Association.

[19]  J. Steibel,et al.  Cationic and neutral amino acid transporter transcript abundances are differentially expressed in the equine intestinal tract. , 2010, Journal of animal science.

[20]  Leslie Z. Benet,et al.  The Role of Transporters in the Pharmacokinetics of Orally Administered Drugs , 2009, Pharmaceutical Research.

[21]  W. Muir,et al.  Chapter 20 – Perioperative Pain Management , 2009 .

[22]  K. Wegner,et al.  Managing severe hoof pain in a horse using multimodal analgesia and a modified composite pain score , 2009 .

[23]  C. Brindley,et al.  Exploratory assessment of dose proportionality: review of current approaches and proposal for a practical criterion , 2009, Pharmaceutical statistics.

[24]  A. Lehner,et al.  Pharmacokinetics of gabapentin in horses. , 2008, Journal of veterinary pharmacology and therapeutics.

[25]  H. Anderson,et al.  Neuropathic changes in equine laminitis pain , 2007, PAIN.

[26]  Jennifer L Davis,et al.  Gabapentin for the treatment of neuropathic pain in a pregnant horse. , 2007, Journal of the American Veterinary Medical Association.

[27]  S. Pyati,et al.  Perioperative Pain Management , 2007, CNS drugs.

[28]  L. Garosi,et al.  Treatment with gabapentin of 11 dogs with refractory idiopathic epilepsy , 2006, Veterinary Record.

[29]  Ole J Bjerrum,et al.  How First‐Time‐in‐Human Studies Are Being Performed: A Survey of Phase I Dose‐Escalation Trials in Healthy Volunteers Published Between 1995 and 2004 , 2005, Journal of clinical pharmacology.

[30]  Jack A. Cook,et al.  The Use of Clinical Trial Simulation to Support Dose Selection: Application to Development of a New Treatment for Chronic Neuropathic Pain , 2003, Pharmaceutical Research.

[31]  Paul R. Thompson,et al.  A Saturable Transport Mechanism in the Intestinal Absorption of Gabapentin Is the Underlying Cause of the Lack of Proportionality Between Increasing Dose and Drug Levels in Plasma , 1993, Pharmaceutical Research.

[32]  F. Vandenhende,et al.  Confidence Interval Criteria for Assessment of Dose Proportionality , 2004, Pharmaceutical Research.

[33]  D. H. Kennedy,et al.  The use of gabapentin for the treatment of postherpetic neuralgia. , 2003, Clinical therapeutics.

[34]  P. Kam,et al.  Gabapentin: pharmacology and its use in pain management , 2002, Anaesthesia.

[35]  McLean Mj Clinical pharmacokinetics of gabapentin. , 1994 .

[36]  M. McLean Clinical pharmacokinetics of gabapentin , 1994, Neurology.

[37]  R. Ramsay Clinical efficacy and safety of gabapentin , 1994, Neurology.

[38]  E. U. Kölle,et al.  Pharmacokinetics and metabolism of gabapentin in rat, dog and man. , 1986, Arzneimittel-Forschung.

[39]  W. K. Read Renal Medullary Crest Necrosis Associated with Phenylbutazone Therapy in Horses , 1983, Veterinary pathology.

[40]  L. Soma,et al.  Renal Papillary Necrosis in Horses after Phenylbutazone and Water Deprivation , 1983, Veterinary pathology.