Varnitrip: Advanced Neuropathic Pain Relief and Symptom Management
Varnitrip
| Product dosage: 0.5mg | |||
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| Product dosage: 1mg | |||
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Synonyms | |||
Varnitrip is a prescription medication formulated with Gabapentin, a well-established anticonvulsant and analgesic agent. It is specifically indicated for the management of postherpetic neuralgia and as adjunctive therapy in the treatment of partial seizures. This product card provides a comprehensive, expert-level overview for healthcare professionals to ensure informed prescribing and patient counseling. Its mechanism of action, while not fully elucidated, is believed to involve binding to the α2δ subunit of voltage-gated calcium channels in the central nervous system, modulating the release of several neurotransmitters.
Features
- Active Pharmaceutical Ingredient: Gabapentin (as per prescribed strength, e.g., 100mg, 300mg, 400mg, 600mg, 800mg)
- Dosage Form: Film-coated tablets for oral administration
- Pharmacotherapeutic Group: Antiepileptics, other antiepileptics
- ATC Code: N03AX12
- High bioavailability with dose-dependent absorption profile
- Excipients include copovidone, talc, and magnesium stearate
- Presented in blister packs within a cardboard carton, with patient information leaflet
Benefits
- Provides significant reduction in the sharp, burning, shooting, or stabbing pain associated with neuropathic conditions.
- Offers a non-opioid therapeutic option for chronic pain management, mitigating risks associated with narcotic analgesics.
- Improves overall quality of life by enabling better sleep and daily function through effective pain control.
- Demonstrates a predictable pharmacokinetic profile in patients with stable renal function, allowing for consistent dosing.
- Serves as an effective add-on therapy for seizure control, reducing frequency and severity in appropriate patient populations.
Common use
Varnitrip is primarily prescribed for two key indications. First, for the management of neuropathic pain following a herpes zoster infection, known as postherpetic neuralgia. This condition is characterized by persistent pain in the area previously affected by the shingles rash. Second, it is used as adjunctive therapy (add-on treatment) in adults and pediatric patients 3 years and older for the control of partial onset seizures, with or without secondary generalization, when existing antiepileptic drug regimens provide insufficient control. Its use must always be initiated and monitored by a physician familiar with the treatment of these conditions.
Dosage and direction
Dosage must be individualized according to the patient’s clinical response and tolerability. For postherpetic neuralgia in adults, therapy should be initiated with a single 300 mg dose on Day 1, followed by 600 mg/day (300 mg two times a day) on Day 2, and 900 mg/day (300 mg three times a day) on Day 3. The dose may be increased as needed for pain relief up to a maximum daily dose of 1800 mg (600 mg three times a day). For epilepsy, the effective dose is 900 to 1800 mg/day in three divided doses. Dosage in patients with compromised renal function must be adjusted based on creatinine clearance. Tablets should be swallowed whole with water and can be taken with or without food. The dosing schedule must be strictly adhered to; the three daily doses should not exceed 12 hours apart.
Precautions
Patients should be advised that Varnitrip (Gabapentin) may cause dizziness, somnolence, and other CNS depressant effects. Caution is advised when operating complex machinery, driving, or engaging in other high-risk activities until the patient’s experience with the drug is established. Abrupt discontinuation of therapy may precipitate withdrawal symptoms, including anxiety, insomnia, nausea, pain, and sweating; therefore, tapering the dose gradually over a minimum of one week is strongly recommended. As with other antiepileptic drugs, Varnitrip should be withdrawn gradually to minimize the potential of increased seizure frequency in patients with seizure disorders. Patients with a history of substance abuse should be closely monitored. Suicidal thoughts and behavior have been reported in patients taking antiepileptic drugs; patients and caregivers should be alert to the emergence or worsening of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts.
Contraindications
Varnitrip is contraindicated in patients with a known hypersensitivity to gabapentin or any of the inactive ingredients in the formulation. A history of angioedema with previous gabapentin use is an absolute contraindication for subsequent use.
Possible side effect
The most frequently observed adverse reactions, which are generally mild to moderate, are dizziness, somnolence, peripheral edema, ataxia, fatigue, and nystagmus. Other side effects can include:
- Very common (≥1/10): Viral infection, fever, nausea, vomiting, somnolence, dizziness, ataxia, fatigue.
- Common (≥1/100 to <1/10): Pneumonia, respiratory infection, urinary tract infection, infection, anorexia, increased appetite, confusion, emotional lability, depression, anxiety, nervousness, thinking abnormal, vertigo, hyperkinesia, dysarthria, amnesia, tremor, insomnia, headache, convulsions, diplopia, amblyopia, hypertension, flushing, diarrhea, abdominal pain, dyspepsia, constipation, dry mouth, flatulence, dental abnormalities, leukopenia, weight increase, myalgia, arthralgia, back pain, fracture, rash, pruritus, abrasion, impotence, urinary incontinence.
- Additional serious side effects include angioedema, hypersensitivity reactions, and sudden unexplained deaths in epilepsy.
Drug interaction
Antacids containing aluminum and magnesium reduce the bioavailability of gabapentin by approximately 20%. It is recommended that Varnitrip be taken at least 2 hours following antacid administration. Gabapentin is not appreciably metabolized nor does it interfere with the metabolism of other commonly co-administered antiepileptic drugs. However, due to its CNS-depressant effects, additive effects can be expected when taken with other agents that cause sedation, such as opioids, benzodiazepines, barbiturates, sedating antihistamines, or alcohol. Morphine co-administration increases gabapentin AUC. Close monitoring is advised.
Missed dose
If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should be instructed not to take a double dose to make up for a missed one.
Overdose
Symptoms of overdose are primarily an extension of its known adverse effects, including severe drowsiness, dizziness, ataxia, slurred speech, and lethargy. Double vision, diarrhea, and mild hypotension have also been reported. Fatal overdoses have been reported, often in combination with other CNS depressants. In the event of a suspected overdose, supportive care is the mainstay of treatment. Hemodialysis may be beneficial due to gabapentin’s low protein binding and primarily renal elimination. Gastric lavage should be considered if presented soon after ingestion. The patient’s airway should be secured, and vital signs monitored.
Storage
Store Varnitrip tablets below 30°C (86°F). Keep the blister strips in the original carton to protect from light and moisture. Keep out of the sight and reach of children. Do not use after the expiration date printed on the packaging.
Disclaimer
This product information is intended for healthcare professionals. It is a summary and does not replace the full Prescribing Information. The prescriber should consult the full SmPC (Summary of Product Characteristics) before initiating treatment. The information provided is based on the current scientific knowledge and licensing status at the time of publishing. The prescriber is responsible for determining the best course of treatment for an individual patient, considering their specific clinical situation.
Reviews
(Compilation of clinical trial data and expert consensus) “Gabapentin, the active ingredient in Varnitrip, has consistently demonstrated efficacy in randomized, double-blind, placebo-controlled trials for postherpetic neuralgia, with a significant number of patients achieving a 50% or greater reduction in pain scores compared to placebo. Its favorable side effect profile and lack of significant drug interactions make it a valuable option in the neuropathic pain arsenal.” - [Summary based on New England Journal of Medicine publications]. “In pediatric and adult epilepsy populations, adjunctive therapy with gabapentin has been shown to produce a statistically significant reduction in seizure frequency versus placebo, establishing its role as an effective broad-spectrum antiepileptic drug.” - [Summary based on Epilepsia journal meta-analyses].