
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: pregabalin
BRAND NAME: Lyrica
DRUG CLASS AND MECHANISM: Pregabalin is an oral medication that is
chemically related to gabapentin
(Neurontin, Gabarone). It is used for treating pain caused by
neurologic diseases such as postherpetic neuralgia as well as
seizures. It also
is used for treating fibromyalgia. The mechanism of action of pregabalin is
unknown. Pregabalin binds to calcium channels on nerves and may modify the
release of neurotransmitters (chemicals that nerves use to communicate with each
other). Reducing communication between nerves may contribute to pregabalin's
effect on pain and seizures. The FDA approved pregabalin in December 2004.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No.
PREPARATIONS: Capsules: 25, 50, 75, 100, 150, 200, 225, and 300 mg
STORAGE: Pregabalin should be stored at room temperature, between
15-30 C (59-86 F).
PRESCRIBED FOR: Pregabalin is used for neuropathic pain associated
with diabetic peripheral neuropathy or postherpetic neuralgia and in combination
with other drugs to treat partial onset seizures in adults. It also is used for
treating fibromyalgia.
DOSING: Pregabalin may be taken with or without food. The initial dose
for neuropathic pain is 50 mg three times a day (150 mg/day). The dose may be
increased to a maximum dose of 100 mg 3 times daily (300 mg/day) after one week.
The recommended starting dose for postherpetic neuralgia is 75 mg twice daily
or 50 mg three times daily. The dose may be increased to 100 mg 3 times daily
(300 mg/day) after one week. If pain relief is inadequate after 2-4 weeks of
treatment at 300 mg/day, the dose may be increased to 300 mg twice daily or 200
mg three times daily. Doses greater than 300 mg cause more side effects.
The recommended dose for treating seizures is 150-600 mg/day divided into 2
or 3 doses.
Fibromyalgia is treated with 300-450 mg/day in 2 or 3 divided doses.
DRUG INTERACTIONS: Alcohol and drugs that cause sedation may increase
the sedative effects of pregabalin. Pioglitazone (Actos) and rosiglitazone
(Avandia) cause weight gain, fluid retention and possibly heart failure.
Therefore, combining pregabalin with these drugs may increase the occurrence of
weight gain and fluid retention.
PREGNANCY: There are no adequate studies of pregabalin in
pregnant
women.
NURSING MOTHERS: It is not known whether pregabalin is excreted in
human breast milk.
SIDE EFFECTS: The most common side effects of pregabalin are
dizziness, drowsiness, dry mouth, edema (accumulation of fluid), blurred vision,
weight gain, and difficulty concentrating. Other side effects include reduced
blood platelet counts, and increased blood creatinine kinase levels. Increased
creatinine kinase can be a sign of muscle injury, and in clinical trials three
patients experienced rhabdomyolysis (severe muscle injury). Therefore, patients
should report unexplained muscle pain, tenderness or weakness to their doctors,
especially if associated with fever and malaise (reduced well-being). Pregabalin
has rarely been associated with angioedema (swelling of the face, tongue, lips,
and gums, throat and larynx).
Last Editorial Review: 9/16/2008
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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