What is your approach to prescribing gabapentin for oral mucositis prophylaxis during chemoradiation?
Has your practice changed based on the randomized, phase 3 study showing prophylactic gabapentin is not effective?
Please share your thoughts and experience.
Answer from: Radiation Oncologist at Community Practice
It can be a useful adjunct therapy, especially for patients getting radiation for oral cavity cancer. Randomized trials have been conflicting but some have shown benefit in a prophylactic setting. In my experience, patients tend to need less narcotic medication (usually able to get by with gabapenti...
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Radiation Oncologist at Genesis Healthcare Partners- San Diego What is a good starting dose in your experience?
Radiation Oncologist at Radiation Oncology Associates With the assistance of a palliative medicine physi...
Answer from: Radiation Oncologist at Community Practice
I routinely prescribe gabapentin during week #1 of head/neck radiation therapy. The reason I start prior to symptom onset is 1.) provides time to titrate dose to meaningful level, 2.) detect intolerance (in my experience, most common intolerance is imbalance/gait instability, which triggers me to st...
Answer from: Radiation Oncologist at Academic Institution
There is randomized evidence that prophylactic gabapentin does not reduce oral mucositis symptoms (Cook et al., PMID 34808255) - I consider in patients who want to consider alternatives to opiates (which is a decent chunk of patients). It is not a completely benign medication though and some patient...
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Radiation Oncologist at Radiation Oncology Associates The devil is in the details. Although a well-desig...
Radiation Oncologist at Emory University I agree that oral cavity is a different treatment ...
What is a good starting dose in your experience?
With the assistance of a palliative medicine physi...