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Gabapentin for itching, information for children after a burn

Why use Gabapentin?

Itchiness after a burn is a common problem experienced by many patients (both adults and children) when the wound area begins to heal. It can slow recovery and cause unnecessary agitation and distress to your child. The intense sensation of itching can cause your child to scratch at fragile areas such as the burn itself and any donor sites. Medicines such as chlorphenamine (Piriton®) and hydroxyzine (Ucerax®, Atarax®) are commonly used to control itch but in many cases these treatments alone are not enough to control the itching. Gabapentin is a medicine normally used to treat epilepsy and certain types of pain, however it has also been found to have powerful anti-itching properties. Gabapentin will sometimes be prescribed to help relieve your child’s itching. It can be prescribed alone or in combination with other medicines that are used to treat the itching. A reduction in itching can usually be seen within a few days of beginning treatment. 

Dosing 

Gabapentin is available in capsule/tablet form and for young children a liquid is also available. How much medicine your child requires depends on their age and weight and the dose will be decided by the doctor. Gabapentin is usually started slowly to help reduce the risk of side effects, for example:

  • Day 1: given ONCE a day
  • Day 2: given TWICE a day
  • Day 3 onwards: given THREE times a day

Duration of treatment

Treatment with Gabapentin should continueuntil the scars heal and the sensation of itching reduces. When a decision is made to stop treatment, the Gabapentin will usually be withdrawn slowly to minimise the chance of any side effects such as restlessness. This may be done over several days and the doctor will advise on a plan as to how to reduce the dose. Side effects such as anxiety, trouble sleeping, nausea, pains and sweating have been reported with suddenly stopping the medicine, so parents and carers should ensure that they never run out of Gabapentin and that they have enough supplies to cover until the next prescription is due.

Common side effects

Most children experience only minor side effects. However, nausea and/or vomiting can occur. These symptoms normally occur in the first one or two days and usually disappear as treatment progresses. Giving the dose of Gabapentin with food (even a snack) can reduce the chance of your child feeling or being sick. Gabapentin can also cause drowsiness and dizziness but again this normally wears off after a few days. Sometimes Gabapentin can cause changes to mood and/or behaviour. If you notice or are concerned about any changes to the child’s mood or behaviour, please report this to your doctor. If you have any questions or concerns about the use of Gabapentin for itching or of the potential side effects below, please discuss with your doctor or pharmacist.

Potential side effects 

Common

Diarrhoea, dry mouth, dyspepsia, nausea, vomiting, constipation, abdominal pain, flatulence, appetite changes, gingivitis, weight gain; hypertension, vasodilation, oedema; dyspnoea, cough, rhinitis; confusion, depression, aggressive behaviour, sleep disturbances, headache, dizziness, anxiety, amnesia, ataxia, dysarthria, nystagmus, tremor, asthenia, paraesthesia, hyperkinesia; influenza-like symptoms; urinary incontinence; leucopenia; myalgia, arthralgia; diplopia, amblyopia, rash, purpura, pruritis, acne; convulsions; vertigo; palpitations.

Rare

Pancreatitis, hepatitis, jaundice, palpitation, hallucinations, movement disorders, thrombocytopaenia, blood-glucose fluctuations in patients with diabetes, tinnitus, acute renal failure, suicidal ideation, Steven-Johnson syndrome, alopecia.

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