This elderly patient had been on a dose of (Neurontin) gabapentin 600 mg three times daily for peripheral neuropathy. Over time, the patient’s kidney function had been declining and was diagnosed with chronic kidney disease.
Family had begun to notice that the patient was becoming more lethargic and dizzy. The patient had also made the comment that they felt “snowed” from time to time. Meclizine was added as needed to help treat the dizziness and the team decided to monitor the other symptoms at this time. The peripheral neuropathy was well managed with no noted pain stated by the patient.
Because of the decline in kidney function the previous dose of gabapentin was now inappropriate especially in this case secondary to the noted adverse effects. Gabapentin is primarily eliminated from the body through the kidney. Gabapentin was reduced and the patient’s symptoms did resolve. The meclizine added for dizziness was also eventually discontinued as we didn’t have any side effects to treat anymore 🙂
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