Pregabalin

Indications
Oral
Postherpetic neuralgia
Adult: 75-150 mg bid. May increase up to 600 mg/day in patients with ongoing pain and can tolerate 300 mg/day.
Renal impairment: Dosage adjustment is required. Patients undergoing haemodialysis should receive a supplementary dose of 25-100 mg immediately after each 4-hr haemodialysis session.
CrCl (ml/min)Dosage Recommendation
30-60Initiate at 75 mg, max dose: 300 mg/day.
15-30Initiate at 25-50 mg, max dose: 150 mg/day.
<15Initiate at 25 mg, max dose: 75 mg/day.

Oral
Adjunct in partial seizures
Adult: 150-600 mg/day. Should be given in 2-3 divided doses. Max dose: 600 mg/day,
Renal impairment: Dosage adjustment is required. Patients undergoing haemodialysis should receive a supplementary dose of 25-100 mg immediately after each 4-hr haemodialysis session.
CrCl (ml/min)Dosage Recommendation
30-60Initiate at 75 mg, max dose: 300 mg/day.
15-30Initiate at 25-50 mg, max dose: 150 mg/day.
<15Initiate at 25 mg, max dose: 75 mg/day.

Oral
Fibromyalgia
Adult: Initiate at 75 mg bid. May increase to 225 mg bid for patients who do not experience sufficient benefit with 300 mg/day.
Renal impairment: Dosage adjustment is required. Patients undergoing haemodialysis should receive a supplementary dose of 25-100 mg immediately after each 4-hr haemodialysis session.
CrCl (ml/min)Dosage Recommendation
30-60Initiate at 75 mg, max dose: 300 mg/day.
15-30Initiate at 25-50 mg, max dose: 150 mg/day.
<15Initiate at 25 mg, max dose: 75 mg/day.

Oral
Anxiety
Adult: Initiate at 150 mg daily. May increase at wkly intervals in steps of 150 mg. Max dose: 600 mg daily.
Renal impairment: Dosage adjustment is required. Patients undergoing haemodialysis should receive a supplementary dose of 25-100 mg immediately after each 4-hr haemodialysis session.
CrCl (ml/min)Dosage Recommendation
30-60Initiate at 75 mg, max dose: 300 mg/day.
15-30Initiate at 25-50 mg, max dose: 150 mg/day.
<15Initiate at 25 mg, max dose: 75 mg/day.


Special Populations: The dose should be adjusted in patients with reduced renal function based on creatinine clearance. CrCl of at least 60 mL/min: 50-100mg tid.
Contraindications
Hypersensitivity. Pregnancy, lactation. Driving or working with machines, or do other dangerous activities.
Warnings / Precautions
Discontinue treatment if patients develop severe angioedema. Withdraw treatment gradually over at least 1 wk. May cause peripheral oedema. Regular vision check is recommended. May decrease platelet count and prolong PR interval.
Adverse Reactions
Dizziness, drowsiness, visual disturbance (including blurred vision, diplopia), ataxia, dysarthria, tremor, lethargy, memory impairment, euphoria, wt gain, constipation, dry mouth, peripheral edema, depression, confusion, agitation, hallucinations, myoclonus, hypoaesthesia, hyperaesthesia, tachycardia, excessive salivation, sweating, flushing, rash, muscle cramp, myalgia, arthralgia, urinary incontinence, dysuria, thrombocytopenia, neutropenia, 1st ° heart block, hypotension, hypertension, pancreatitis, dysphagia, oliguria, rhabdomyolysis.
Drug Interactions
Concurrent use with oxycodone, lorazepam and ethanol may increase the CNS effects.
See Below for More pregabalin Drug Interactions
Mechanism of Actions
Pregabalin is an analog of the neurotransmitter GABA. It binds potently to the alpha2-delta subunit resulting in modulation of Ca channels and reduction in the release of several neurotransmitters, including glutamate, norepinephrine, serotonin, dopamine, and substance P.
Absorption: Rapidly absorbed after oral doses. Peak plasma concentrations are achieved within 1.5 hr.
Distribution: Not bound to plasma proteins.
Metabolism: Negligible metabolism.
Excretion: About 98% excreted unchanged in urine. Elimination half life: about 6.3 hr.
Administration
May be taken with or without food.
Storage Conditions
Oral: Store at 25°C.
ATC Classification
N03AX16 - pregabalin ; Belongs to the class of other antiepileptics.
Storage
Oral: Store at 25°C.
Available As
  • Pregabalin 10 mg
  • Pregabalin 100 mg
  • Pregabalin 150 mg
  • Pregabalin 20 mg
  • Pregabalin 300 mg
  • Pregabalin 40 mg
  • Pregabalin 5 mg
  • Pregabalin 50 mg
  • Pregabalin 75 mg
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