Titrate Pendine to an 1800 mg dose taken orally once daily with the evening meal. Pendine tablets should be swallowed whole. Do not split, crush, or chew the tablets.

If Pendine dose is reduced, discontinued, or substituted with an alternative medication, this should be done gradually over a minimum of one week or longer (at the discretion of the prescriber).

In adults with postherpetic neuralgia, Pendine therapy should be initiated and titrated as follows:

Table 1: Pendine Recommended Titration Schedule
	Day 1	Day 2	Days 3-6	Days 7-10	Days 11-14	Day 15
Daily Dose	300 mg	600 mg	900 mg	1200 mg	1500 mg	1800 mg

Patients with Renal Impairment

In patients with stable renal function, creatinine clearance (CCr) can be reasonably well estimated using the equation of Cockcroft and Gault:

For females CCr=(0.85)(140-age)(weight)/[(72)(SCr)]

For males CCr=(140-age)(weight)/[(72)(SCr)]

where age is in years, weight is in kilograms and SCr is serum creatinine in mg/dL.

The dose of Pendine should be adjusted in patients with reduced renal function, according to Table 2. Patients with reduced renal function must initiate Pendine at a daily dose of 300 mg. Pendine should be titrated following the schedule outlined in Table 1. Daily dosing in patients with reduced renal function must be individualized based on tolerability and desired clinical benefit.

Table 2: Pendine Dosage Based on Renal Function
Once-daily dosing
Creatinine Clearance (mL/min)	Pendine Dose (once daily with evening meal)
≥ 60	1800 mg
30 - 60	600 mg to 1800 mg
< 30	Pendine should not be administered
patients receiving hemodialysis	Pendine should not be administered

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Postherpetic Neuralgia

What other drugs will affect Pendine?

Taking Pendine with other drugs that make you sleepy or slow your breathing can worsen these effects. Ask your doctor before taking Pendine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Pendine, especially:

hydrocodone, (Lortab, Vicodin and others);
morphine (Kadian, MS Contin, Oramorph, and others); or
naproxen (Naprosyn, Aleve, Anaprox, and others).

This list is not complete and other drugs may interact with Pendine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Pendine interactions

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In vitro studies were conducted to investigate the potential of Pendine to inhibit the major cytochrome P450 enzymes (CYP1A2, CYP2A6, CYP2C9, CYP2C19, CYP2D6, CYP2E1, and CYP3A4) that mediate drug and xenobiotic metabolism using isoform selective marker substrates and human liver microsomal preparations. Only at the highest concentration tested (171 mcg/mL; 1mM) was a slight degree of inhibition (14% to 30%) of isoform CYP2A6 observed. No inhibition of any of the other isoforms tested was observed at Pendine concentrations up to 171 mcg/mL (approximately 15 times the Cmax at 3600 mg/day).

Pendine is not appreciably metabolized nor does it interfere with the metabolism of commonly coadministered antiepileptic drugs.

The drug interaction data described in this section were obtained from studies involving healthy adults and adult patients with epilepsy.

Phenytoin

In a single (400 mg) and multiple dose (400 mg three times daily) study of Pendine immediate release in epileptic patients (N=8) maintained on phenytoin monotherapy for at least 2 months, Pendine had no effect on the steady-state trough plasma concentrations of phenytoin and phenytoin had no effect on Pendine pharmacokinetics.

Carbamazepine

Steady-state trough plasma carbamazepine and carbamazepine 10, 11 epoxide concentrations were not affected by concomitant Pendine immediate release (400 mg three times daily; N=12) administration. Likewise, Pendine pharmacokinetics were unaltered by carbamazepine administration.

Valproic Acid

The mean steady-state trough serum valproic acid concentrations prior to and during concomitant Pendine immediate release administration (400 mg three times daily; N=17) were not different and neither were Pendine pharmacokinetic parameters affected by valproic acid.

Phenobarbital

Estimates of steady-state pharmacokinetic parameters for phenobarbital or Pendine immediate release (300 mg three times daily; N=12) are identical whether the drugs are administered alone or together.

Naproxen

Coadministration of single doses of naproxen (250 mg) and Pendine immediate release (125 mg) to 18 volunteers increased Pendine absorption by 12% to 15%. Pendine immediate release had no effect on naproxen pharmacokinetics. The doses are lower than the therapeutic doses for both drugs. The effect of coadministration of these drugs at therapeutic doses is not known.

Hydrocodone

Coadministration of Pendine immediate release (125 mg and 500 mg) and hydrocodone (10 mg) reduced hydrocodone Cmax by 3% and 21%, respectively, and AUC by 4% and 22%, respectively. The mechanism of this interaction is unknown. Pendine AUC values were increased by 14%; the magnitude of the interaction at other doses is not known.

Morphine

When a single dose (60 mg) of controlled-release morphine capsule was administered 2 hours prior to a single dose (600 mg) of Pendine immediate release in 12 volunteers, mean Pendine AUC values increased by 44% compared to Pendine immediate release administered without morphine. The pharmacokinetics of morphine were not affected by administration of Pendine immediate release 2 hours after morphine. The magnitude of this interaction at other doses is not known.

Cimetidine

Cimetidine 300 mg decreased the apparent oral clearance of Pendine by 14% and creatinine clearance by 10%. The effect of Pendine immediate release on cimetidine was not evaluated. This decrease is not expected to be clinically significant.

Oral Contraceptives

Pendine immediate release (400 mg three times daily) had no effect on the pharmacokinetics of norethindrone (2.5 mg) or ethinyl estradiol (50 mcg) administered as a single tablet, except that the Cmax of norethindrone was increased by 13%. This interaction is not considered to be clinically significant.

Antacid (containing aluminum hydroxide and magnesium hydroxide)

An antacid containing aluminum hydroxide and magnesium hydroxide reduced the bioavailability of Pendine immediate release by about approximately 20%, but by only 5% when Pendine immediate release was taken 2 hours after the antacid. It is recommended that

Pendine be taken at least 2 hours following the antacid (containing aluminum hydroxide and magnesium hydroxide) administration.

Probenecid

Pendine immediate release pharmacokinetic parameters were comparable with and without probenecid, indicating that Pendine does not undergo renal tubular secretion by the pathway that is blocked by probenecid.

Drug/Laboratory Test Interactions

False positive readings were reported with the Ames-N-Multistix SG® dipstick test for urine protein when Pendine was added to other antiepileptic drugs; therefore, the more specific sulfosalicylic acid precipitation procedure is recommended to determine the presence of urine protein.

Drug Abuse And Dependence

The abuse and dependence potential of Pendine has not been evaluated in human studies.

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References

DailyMed. "GABAPENTIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
FDA/SPL Indexing Data. "6CW7F3G59X: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
MeSH. "Excitatory Amino Acid Antagonists". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Pendine are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Pendine. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

10 consumers reported frequency of use

How frequently do I need to take Pendine?
It was reported by ndrugs.com website users that Pendine should ideally be taken Once in a day as the most common frequency of the Pendine. You should you adhere strictly to the instructions and guidelines provided by your doctor on how frequently this Pendine should be taken. Get another patient's view on how frequent the capsule should be used by clicking here.

	Users		%
Once in a day	9		90.0%
Twice in a day	1		10.0%

18 consumers reported doses

What doses of Pendine drug you have used?
The drug can be in various doses. Most anti-diabetic, anti-hypertensive drugs, pain killers, or antibiotics are in different low and high doses and prescribed by the doctors depending on the severity and demand of the condition suffered by the patient. In our reports, ndrugs.com website users used these doses of Pendine drug in following percentages. Very few drugs come in a fixed dose or a single dose. Common conditions, like fever, have almost the same doses, e.g., [acetaminophen, 500mg] of drug used by the patient, even though it is available in various doses.

	Users	%
1-5mg	9	50.0%
6-10mg	8	44.4%
201-500mg	1	5.6%

Consumer reviews

Christa Claassen	14 Apr 2023 16:10
	IMy friend have hives itchyness and rash on legs after Starting this medication

Information checked by Dr. Sachin Kumar, MD Pharmacology

Pendine Dosage

Dosage of Pendine in details