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Gabapentin (Neurontin® , Gabapentin) Available as tablets or capsules. Capsules, Tablets Available as soluble tablets? No Available as a liquid? The recommendation for Gabapentin is not to compound a liquid using the tablet or capsule, but to use the suspension. Reports have suggested increased adverse effects when switching generic formulations of antiepileptic drugs, particularly with gabapentin. 45 I have been given the dubious honour of writing a best practice statement concerning the administration of medication via peg tube. I have found a suggestion that we should administer each individual liquid medication seperately Wright D (2002) Swallowing difficulties protocol: medication administration. Nursing Standard. 17, 14-15, 43-45. Date of acceptance: September 28 2002. This table has NEEMMC GUIDELINES FOR TABLET CRUSHING AND ADMINISTRATION VIA ENTERAL FEEDING TUBES KEY TO DRUG ADMINISTRATION GUIDELINES Please follow the guidelines in order, as shown in the chart (i.e. number 1 is the first choice of which form to administer the drug in). A Tablet will disperse in 1-2 minutes. B Tablet will disperse in greater than 2 minutes. C Liquid preparation available. D Dilute Using these products through enteral tubes may reduce medication efficacy. It is recommended to use sterile or filtered water for preparation and flushing of medications. Some modified-release capsules contain modified-release beads or granules which can be administered in water or on soft food to patients with swallowing difficulties. The following liquid medicines manufactured by Rosemont Pharmaceuticals have recently received UK licenses for administration via nasogastric (NG) or percutaneous endoscopic gastronomy (PEG) tube: Furosemide Oral Solution 20mg/5mL, 40mg/5mL and 50mg/5mL Ramipril Oral Solution 2.5mg/5mL Metoclopramide Hydrochloride Oral Solution 5mg/5mL Clonazepam Oral Solution 0.5mg/mL, 2mg/mL Gabapentin Oral Capsules and Tablets: Many short-acting tablets may be pulverized into a fine powder and diluted with water to form a slurry appropriate for EFT administration. The contents of certain capsules may also be mixed with water to be given in a similar man-ner. Opening The Capsules The good news is if you are having trouble swallowing (gabapentin) capsules, they can safely be opened, and the contents of the capsule can be sprinkled onto food or into a drink for immediate consumption. Several studies have shown that opening the capsules and using the powder will not negatively affect the drug. Enteral feeding tubes can be inserted via a number of routes: via the nasopharynx, for example nasogastric (NG) or nasojejunal (NJ), or via direct access to the GI tract through the skin, for example gastrostomy or jejunostomy tubes. Gabapentin Colonis 50mg/ml Oral Solution - Summary of Product Characteristics (SmPC) by Colonis Pharma Ltd Providing recommendations for in vitro testing of oral drug products administered via enteral tube will support the development of clear, product-specific enteral tube administration instructions Instructions for administration via nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tubes. Ensure that the enteral feeding tube is free from obstruction before administration. Flush the enteral tube with water, using the minimum fl ush volume required. A potential complication with pouring capsule contents through any enteral access device is that tube occlusions may occur, so large-bore feeding tubes (≥14 French) are preferred. Various studies have discussed alternative methods for delivering omeprazole and lansoprazole via enteral feeding tubes. [55, 56, 57, 58] When administered through large-bore NG or gastrostomy Gabapentin capsule contents can be dispersed and stirred in 15ml water immediately prior to taking (unlicensed use)1. Administration in enteral feeding tube. Gabapentin Colonis and Rosemont oral solution can be administered via NG or PEG tube (Rosemont: silicone, polyurethane or PVC. Appendix 10: Administering drugs via feeding tubes Administering drugs via feeding tubes is generally an unlicensed activity. There is little published data and most recommendations are theoretical and/or based on local policy. An alternative licensed option may therefore be preferable, e.g. rectal or parenteral formulations. However, if given by tube, there is a range of possibilities (Figure Stop feed and/or flush enteral tube with 15-30mL of water prior to drug administration. Ensure the patient is sitting up at an angle of at least 30 degrees to avoid reflux of medication or water. Give medication via enteral tube as directed by the guidance within the table. Many medications may be put into your PEG. Here are some important things you need to know: If any medications cannot be put in your PEG, your pharmacist may help you by reaching out to the healthcare provider that prescribed a medication to suggest another option. In patients dependent on nasogastric or PEG tubes, drugs are often crushed into a powder and suspended in water to enable its passage through the tubes. Typically, when drugs are crushed, multiple tablets are crushed together and then mixed and put in one sachet.
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