Gabapentin should be used with caution in patients with renal impairment and in those undergoing haemodialysis. False positive readings have been reported with some urinary protein tests in patients taking gabapentin. Care is required whey withdrawing gabapentin therapy.
Use on Driving or Machine Operation: Driving by patients with epilepsy is generally regulated and restricted to those whose seizures are adequately controlled. Also, antiepileptic drugs may produce CNS-related adverse effects, including dizziness and drowsiness, that could impair a patient's ability to drive a vehicle or operate machinery, particularly during the initial stages of therapy.
Use in Pregnancy & Lactation: Gabapentin is actively transported across the placenta and accumulates in the fetus although its effect was unclear. All the deliveries, including one preterm, were uneventful and all of the infants were healthy, apart from one who became cyanosed and mildly hypotonic 8 hours after birth. The distribution of gabapentin into breast milk was extensive and neonates were found to have a lower capacity to eliminate gabapentin than adults, with an elimination half-life of about 14 hours. However, the plasma concentrations in the breast-fed infants appeared to be low and the relative infant dose was estimated to be 1.3 to 3.8% of the mothers' weight-adjusted dose at 0.2 to 1.3 mg/kg daily. No adverse effects were reported in the infants, and the authors considered that gabapentin was generally safe during breast feeding.