Gabapentin enacarbil extended release for the treatment of postherpetic neuralgia in adults

Ben M Thomas,¹ Paul Farquhar-Smith<sup>2

1</sup>Chelsea Westminster Hospital, London, UK; ²Department of Anaesthetics, The Royal Marsden NHS Foundation Trust, London, UK

Abstract: The development of biomedical technology is allowing refinement of drug therapies in order to improve medication profiles and benefit patients. Gabapentin (Gp) is a medication licensed globally for various indications, including postherpetic neuralgia. It has a pharmacokinetic profile which has been suggested may limit its clinical effects and reduce medication compliance. In 2012, the US Food and Drug Administration licensed a novel preparation which aims to circumvent these limitations. Gp enacarbil is a prodrug of Gp, which is additionally prepared in an extended release preparation. The resulting compound has an improved absorption profile and a reduced dosing frequency in comparison to immediate release Gp. An absence of comparative data, however, limits the direct evaluation of the medication to both immediate release and other extended release preparations available on the market. Additionally, no data are currently available addressing efficacy, tolerability, or side effects with other first line treatments of postherpetic neuralgia. Additional experimental data should be sought to clarify the position of Gp enacarbil, both within postherpetic neuralgia treatment protocols and in relation to the increasing numbers of gabapentinoids available.

Keywords: postherpetic neuralgia, garbapentin enacarbil, herpes zoster