Transdermal vs. oral gabapentin

[njg55]

I have a cat with stomatitis. Full mouth extraction didn't help, and she's now had three cryotherapy sessions with a fourth scheduled in a month. The dental vet prescribed transdermal gabapentin. After the first treatment, I consulted a feline vet specialist who had referred me to the dentist, and she told me the transdermal doesn't work and prescribed a liquid. I didn't feel my cat needed the gabapentin after the second cryotherapy procedure, but today, after the third, I was informed her condition had worsened and she should use the gaba again. I requested a refill of the transdermal, since I decided it's best to stick with what the dentist prefers. Also, I've learned that another medication prescribed by the cat specialist was much more harmful than helpful and was largely responsible for today's negative follow-up, so I have less faith in her recommendations now. Is there any consensus on the relative efficacy of transdermal vs. oral gabapentin? I want my cat to benefit from the medication, but it's impossible for me to know which doctor is correct here about the best formulation. A click pen with the transdermal medication would certainly be easier to use; I've been giving another cat a different med that way for several months (and the consensus is that in this case, transdermal is effective!).

 

[Sonatine]

Based on this study that I just read, it seems that gabapentin is not well absorbed transdermally. Here it is if you're curious:

The pharmacokinetics of gabapentin in cats

Gabapentin is the most commonly prescribed medication for the treatment of chronic musculoskeletal pain in cats. Despite this common and chronic usage, clinically relevant pharmacokinetic data is lacking.To evaluate the pharmacokinetics of clinically ...

www.ncbi.nlm.nih.gov

Admittedly, this was a fairly small study, so I'm not sure if it's enough to say that transdermal gabapentin doesn't work at all, but there's definitely a possibility that the dosing will be inconsistent based on the findings.

 

[jen]

From my experience, transdermal meds are never truly as effective as oral.

 

[njg55]

I think I found that study earlier, since I've been wrestling with this question for several months. Based on that, or whatever I read, I opted for the liquid from a compounding pharmacy after Luna's first cryotherapy procedure. At this point, since my cat will be seeing the dental specialist again in a month, I think I'll use the transdermal that she prescribed. I don't have full confidence in it, but this vet probably prescribes it frequently and presumably has had some follow-up from her clients about how well it works, or other reasons (hopefully evidence-based) for this recommendation. It's hard for us, as human patients or on behalf of our pets, to deal with conflicting opinions, but doctors can and do have different treatment approaches (and in humans, possibly in animals, it's also true that the same medication or formulation will affect two individuals differently for many possible reasons. Maybe Luna will be lucky).

, post: 5089275, member: 10017207"]
Based on this study that I just read, it seems that gabapentin is not well absorbed transdermally. Here it is if you're curious:

http://[URL]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6271300/

[/URL]

Admittedly, this was a fairly small study, so I'm not sure if it's enough to say that transdermal gabapentin doesn't work at all, but there's definitely a possibility that the dosing will be inconsistent based on the findings.
[/QUOTE]
I

 

[LTS3]

From my experience, transdermal meds are never truly as effective as oral.

Yes. Transdermal medications take longer to work than medicines that are ingested or injected and they may not even be as effective. The skin is a barrier that the medicine is slowly absorbed by in order to get to the bloodstream.