What is your approach to prescribing gabapentin for oral mucositis prophylaxis during chemoradiation?

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...

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...

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...