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Gabapentin for the Prevention of CINV

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Management of Chemotherapy-Induced Nausea and Vomiting
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Abstract

Gabapentin is a gamma-aminobutyric acid (GABA) analogue initially approved by the Food and Drug Administration (FDA) in 1993 for the treatment of seizures. Gabapentin was soon found to be highly effective for treating neuropathic pain [1] and then restless legs syndrome [2] and presently is FDA approved for all three indications. Despite its chemical structure, gabapentin has no effect on GABA receptors or GABA breakdown by GABA transaminase but does increase brain GABA synthesis in rats and humans [3, 4]. Gabapentin’s mechanism of action for treating neuropathic pain, which is its main clinical use, is dependent upon its binding to the alpha-2/delta subunit of neuronal voltage-gated calcium channels [5] and likely involves the mitigation of neuronal calcium currents [6, 7].

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References

  1. Backonja M, Beydoun A, Edwards KR et al (1998) Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 280:1831–1836

    Article  CAS  PubMed  Google Scholar 

  2. Garcia-Borreguero D, Larrosa O, de la Llave Y, Verger K, Masramon X, Hernandez G (2002) Treatment of restless legs syndrome with gabapentin: a double-blind, cross-over study. Neurology 59:1573–1579

    Article  CAS  PubMed  Google Scholar 

  3. Chadwick D (1992) Gabapentin. In: Pedley TA, Meldrum BS (eds) Recent advances in epilepsy. Churchill-Livingstone, Edinburgh, pp 211–221

    Google Scholar 

  4. Taylor CP (1997) Mechanisms of action of gabapentin. Rev Neurol (Paris) 153(Suppl 1):S39–S45

    Google Scholar 

  5. Taylor CP (2004) The biology and pharmacology of calcium channel (alpha)2(delta) proteins. Pfizer satellite symposium to the 2003 Society for Neuroscience Meeting. Sheraton New Orleans Hotel, New Orleans, LA November 10, 2003. CNS Drug Rev 10:183–188

    Article  PubMed  Google Scholar 

  6. Fink K, Dooley DJ, Meder WP et al (2002) Inhibition of neuronal Ca(2+) influx by gabapentin and pregabalin in the human neocortex. Neuropharmacology 42:229–236

    Article  CAS  PubMed  Google Scholar 

  7. Sutton KG, Martin DJ, Pinnock RD, Lee K, Scott RH (2002) Gabapentin inhibits high-threshold calcium channel currents in cultured rat dorsal root ganglion neurones. Br J Pharmacol 135:257–265

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Guttuso TJ Jr (2000) Gabapentin’s effects on hot flashes and hypothermia. Neurology 54:2161–2163

    Article  PubMed  Google Scholar 

  9. Guttuso T Jr (2012) Effective and clinically meaningful non-hormonal hot flash therapies. Maturitas 72:6–12

    Article  PubMed  Google Scholar 

  10. Guttuso T Jr, Roscoe J, Griggs J (2003) Effect of gabapentin on nausea induced by chemotherapy in patients with breast cancer. Lancet 361:1703–1705

    Article  CAS  PubMed  Google Scholar 

  11. Pater JL, Lofters WS, Zee B et al (1997) The role of the 5-HT3 antagonists ondansetron and dolasetron in the control of delayed onset nausea and vomiting in patients receiving moderately emetogenic chemotherapy. Ann Oncol 8:181–185

    Article  CAS  PubMed  Google Scholar 

  12. Dexamethasone alone or in combination with ondansetron for the prevention of delayed nausea and vomiting induced by chemotherapy. The Italian Group for Antiemetic Research (2000) N Engl J Med 342:1554–1559

    Google Scholar 

  13. Kris MG, Gralla RJ, Clark RA et al (1985) Incidence, course, and severity of delayed nausea and vomiting following the administration of high-dose cisplatin. J Clin Oncol 3:1379–1384

    CAS  PubMed  Google Scholar 

  14. Guttuso T Jr, Robinson LK, Amankwah KS (2010) Gabapentin use in hyperemesis gravidarum: a pilot study. Early Hum Dev 86:65–66

    Article  CAS  PubMed  Google Scholar 

  15. Shistik E, Ivanina T, Puri T, Hosey M, Dascal N (1995) Ca2+ current enhancement by alpha 2/delta and beta subunits in Xenopus oocytes: contribution of changes in channel gating and alpha 1 protein level. J Physiol 489:55–62

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Navari RM, Reinhardt RR, Gralla RJ et al (1999) Reduction of cisplatin-induced emesis by a selective neurokinin-1-receptor antagonist. L-754,030 Antiemetic Trials Group. N Engl J Med 340:190–195

    Article  CAS  PubMed  Google Scholar 

  17. Luo ZD, Chaplan SR, Higuera ES et al (2001) Upregulation of dorsal root ganglion (alpha)2(delta) calcium channel subunit and its correlation with allodynia in spinal nerve-injured rats. J Neurosci 21:1868–1875

    CAS  PubMed  Google Scholar 

  18. Guttuso T Jr (2014) Gabapentin’s anti-nausea and anti-emetic effects: a review. Exp Brain Res 232:2535–2539

    Article  CAS  PubMed  Google Scholar 

  19. Jahromi HE, Gholami M, Rezaei F (2013) A randomized double-blinded placebo controlled study of four interventions for the prevention of postoperative nausea and vomiting in maxillofacial trauma surgery. J Craniofac Surg 24:e623–e627

    Article  PubMed  Google Scholar 

  20. Misra S, Parthasarathi G, Vilanilam GC (2013) The effect of gabapentin premedication on postoperative nausea, vomiting, and pain in patients on preoperative dexamethasone undergoing craniotomy for intracranial tumors. J Neurosurg Anesthesiol 25:386–391

    Article  PubMed  Google Scholar 

  21. Ajori L, Nazari L, Mazloomfard MM, Amiri Z (2012) Effects of gabapentin on postoperative pain, nausea and vomiting after abdominal hysterectomy: a double blind randomized clinical trial. Arch Gynecol Obstet 285:677–682

    Article  CAS  PubMed  Google Scholar 

  22. Khademi S, Ghaffarpasand F, Heiran HR, Asefi A (2010) Effects of preoperative gabapentin on postoperative nausea and vomiting after open cholecystectomy: a prospective randomized double-blind placebo-controlled study. Med Princ Pract 19:57–60

    Article  PubMed  Google Scholar 

  23. Mohammadi SS, Seyedi M (2008) Effects of gabapentin on early postoperative pain, nausea and vomiting in laparoscopic surgery for assisted reproductive technologies. Pak J Biol Sci: PJBS 11:1878–1880

    Article  PubMed  Google Scholar 

  24. Pandey CK, Priye S, Ambesh SP, Singh S, Singh U, Singh PK (2006) Prophylactic gabapentin for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled study. J Postgrad Med 52:97–100

    CAS  PubMed  Google Scholar 

  25. Guttuso T Jr, Vitticore P, Holloway RG (2005) Responsiveness of life-threatening refractory emesis to gabapentin-scopolamine therapy following posterior fossa surgery. Case Rep J Neurosurg 102:547–549

    Google Scholar 

  26. Barton DL, Thanarajasingam G, Sloan JA et al (2014) Phase III double-blind, placebo-controlled study of gabapentin for the prevention of delayed chemotherapy-induced nausea and vomiting in patients receiving highly emetogenic chemotherapy. NCCTG N08C3 (Alliance). Cancer

    Google Scholar 

  27. Cruz FM, de Iracema Gomes Cubero D, Taranto P et al (2012) Gabapentin for the prevention of chemotherapy- induced nausea and vomiting: a pilot study. Support Care Cancer 20:601–606

    Article  PubMed  Google Scholar 

  28. Spiegel DR, Webb K (2012) A case of treatment refractory hyperemesis gravidarum in a patient with comorbid anxiety, treated successfully with adjunctive gabapentin: a review and the potential role of neurogastroentereology in understanding its pathogenesis and treatment. Innov Clin Neurosci 9:31–38

    PubMed Central  PubMed  Google Scholar 

  29. Erol DD (2011) The analgesic and antiemetic efficacy of gabapentin or ergotamine/caffeine for the treatment of postdural puncture headache. Adv Med Sci 56:25–29

    Article  CAS  PubMed  Google Scholar 

  30. Pandya KJ, Morrow GR, Roscoe JA et al (2005) Gabapentin for hot flashes in 420 women with breast cancer: a randomised double-blind placebo-controlled trial. Lancet 366:818–824

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Reddy SY, Warner H, Guttuso T Jr et al (2006) Gabapentin, estrogen, and placebo for treating hot flushes: a randomized controlled trial. Obstet Gynecol 108:41–48

    Article  CAS  PubMed  Google Scholar 

  32. Backonja M, Glanzman RL (2003) Gabapentin dosing for neuropathic pain: evidence from randomized, placebo-controlled clinical trials. Clin Ther 25:81–104

    Article  CAS  PubMed  Google Scholar 

  33. AGidal BE, Radulovic LL, Kruger S, Rutecki P, Pitterle M, Bockbrader HN (2000) Inter- and intra-subject variability in gabapentin absorption and absolute bioavailability. Epilepsy Res 40:123–127

    Article  Google Scholar 

  34. Guttuso T Jr, Kurlan R, McDermott MP, Kieburtz K (2003) Gabapentin’s effects on hot flashes in postmenopausal women: a randomized controlled trial. Obstet Gynecol 101:337–345

    Article  CAS  PubMed  Google Scholar 

  35. Warr DG, Hesketh PJ, Gralla RJ et al (2005) Efficacy and tolerability of aprepitant for the prevention of chemotherapy-induced nausea and vomiting in patients with breast cancer after moderately emetogenic chemotherapy. J Clin Oncol 23:2822–2830

    Article  CAS  PubMed  Google Scholar 

  36. Pacheco A, Verschraegen CF, Mangalik A, Cheshire S, Royce ME (2008) A randomized open-label comparison of aprepitant (A) versus gabapentin (G) in the prevention of the refractory nausea and vomiting associated with moderately and severely emetogenic chemotherapy. J Clin Oncol 26(Suppl):20509

    Google Scholar 

  37. Martin AR, Pearson JD, Cai B, Elmer M, Horgan K, Lindley C (2003) Assessing the impact of chemotherapy-induced nausea and vomiting on patients’ daily lives: a modified version of the Functional Living Index-Emesis (FLIE) with 5-day recall. Support Care Cancer 11:522–527

    Article  CAS  PubMed  Google Scholar 

  38. Haiderali A, Menditto L, Good M, Teitelbaum A, Wegner J (2011) Impact on daily functioning and indirect/direct costs associated with chemotherapy-induced nausea and vomiting (CINV) in a U.S. population. Support Care Cancer 19:843–851

    Article  PubMed  Google Scholar 

  39. Bloechl-Daum B, Deuson RR, Mavros P, Hansen M, Herrstedt J (2006) Delayed nausea and vomiting continue to reduce patients’ quality of life after highly and moderately emetogenic chemotherapy despite antiemetic treatment. J Clin Oncol 24:4472–4478

    Article  CAS  PubMed  Google Scholar 

  40. Griffin AM, Butow PN, Coates AS et al (1996) On the receiving end. V: patient perceptions of the side effects of cancer chemotherapy in 1993. Ann Oncol 7:189–195

    Article  CAS  PubMed  Google Scholar 

  41. Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A (2002) Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am J Obstet Gynecol 186:S228–S231

    Article  PubMed  Google Scholar 

  42. Pleil AM, Coyne KS, Reese PR, Jumadilova Z, Rovner ES, Kelleher CJ (2005) The validation of patient-rated global assessments of treatment benefit, satisfaction, and willingness to continue – the BSW. Value Health: J Int Soc Pharmacoeconomics Outcome Res 8(Suppl 1):S25–S34

    Article  Google Scholar 

  43. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989) The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46:1121–1123

    Article  CAS  PubMed  Google Scholar 

  44. Radulovic LL, Turck D, von Hodenberg A et al (1995) Disposition of gabapentin (neurontin) in mice, rats, dogs, and monkeys. Drug Metab Dispos 23:441–448

    CAS  PubMed  Google Scholar 

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Correspondence to Thomas J. Guttuso Jr. MD .

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Guttuso, T.J. (2016). Gabapentin for the Prevention of CINV. In: Navari, R. (eds) Management of Chemotherapy-Induced Nausea and Vomiting. Adis, Cham. https://doi.org/10.1007/978-3-319-27016-6_7

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  • DOI: https://doi.org/10.1007/978-3-319-27016-6_7

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  • Publisher Name: Adis, Cham

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