pregabalin

Pronunciation

Generic Name: pregabalin (pre GAB a lin)
Brand Name: Lyrica

What is pregabalin?

Pregabalin is an anti-epileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures. Pregabalin also affects chemicals in the brain that send pain signals across the nervous system.

Pregabalin is used to control seizures and to treat fibromyalgia. It is also used to treat pain caused by nerve damage in people with diabetes (diabetic neuropathy), herpes zoster (post-herpetic neuralgia), or spinal cord injury.

Pregabalin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about pregabalin?

You may have thoughts about suicide while taking this medication. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, insomnia, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Slideshow: 2014 Update - First Time Brand-to-Generic Switches

If you are taking pregabalin to prevent seizures, keep taking the medication even if you feel fine.

Do not stop using pregabalin without first talking to your doctor, even if you feel fine. You may have increased seizures or withdrawal symptoms such as headache, sleep problems, nausea, and diarrhea. Ask your doctor how to avoid withdrawal symptoms when you stop using pregabalin.

Do not change your dose of pregabalin without your doctor's advice. Tell your doctor if the medication does not seem to work as well in treating your condition.

Wear a medical alert tag or carry an ID card stating that you take pregabalin. Any medical care provider who treats you should know that you take seizure medication.

What should I discuss with my healthcare provider before taking pregabalin?

You should not use this medication if you are allergic to pregabalin.

To make sure you can safely take pregabalin, tell your doctor if you have any of these other conditions:

  • congestive heart failure;

  • diabetes (unless you are taking pregabalin to treat diabetic neuropathy);

  • kidney disease (or if you are on dialysis);

  • a bleeding disorder;

  • low levels of platelets in your blood;

  • a history of depression or suicidal thoughts;

  • a history of drug or alcohol addiction; or

  • if you have ever had a severe allergic reaction.

You may have thoughts about suicide while taking this medication. Tell your doctor if you have new or worsening depression or suicidal thoughts during the first several months of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

FDA pregnancy category C. It is not known whether pregabalin will harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. Tell your doctor right away if you become pregnant while taking pregabalin for seizures. Do not start or stop taking pregabalin during pregnancy without your doctor's advice.

If you become pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of pregabalin on the baby.

It is not known whether pregabalin passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using pregabalin.

If a man fathers a child while using this medication, the baby may have birth defects. Use a condom to prevent pregnancy during your treatment.

Do not give this medication to a child younger than 18 years old.

How should I take pregabalin?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

You may take pregabalin with or without food.

Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not change your dose of pregabalin without your doctor's advice. Tell your doctor if the medication does not seem to work as well in treating your condition.

Call your doctor if you have any problems with your vision while taking pregabalin.

If you are taking pregabalin to prevent seizures, keep taking it even if you feel fine. You may have an increase in seizures if you stop taking pregabalin. Follow your doctor's instructions.

Do not stop using pregabalin without first talking to your doctor, even if you feel fine. You may have increased seizures or withdrawal symptoms such as headache, sleep problems, nausea, and diarrhea. Ask your doctor how to avoid withdrawal symptoms when you stop using pregabalin.

Wear a medical alert tag or carry an ID card stating that you take pregabalin. Any medical care provider who treats you should know that you take seizure medication.

Store at room temperature away from moisture, light, and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking pregabalin?

Drinking alcohol can increase certain side effects of pregabalin.

Pregabalin may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Pregabalin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

  • muscle pain, weakness, or tenderness (especially if you also have a fever and feel tired);

  • vision problems;

  • easy bruising or bleeding; or

  • swelling in your hands or feet, rapid weight gain.

Less serious side effects may include:

  • dizziness, drowsiness;

  • loss of balance or coordination;

  • problems with memory or concentration;

  • breast swelling;

  • tremors; or

  • dry mouth, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Pregabalin dosing information

Usual Adult Dose for Diabetic Neuropathy:

Initial dose: 50 mg 3 times a day

The maximum recommended dose is 100 mg 3 times a day in patients with a creatinine clearance of at least 60 mL/min.

The dose may be increased to 100 mg 3 times a day within 1 week based on efficacy and tolerability.

Usual Adult Dose for Postherpetic Neuralgia:

Initial dose: 75 mg 2 times a day or 50 mg 3 times a day in patients with a creatinine clearance of at least 60 mL/min

The dose may be increased to 100 mg 3 times a day within 1 week based on efficacy and tolerability.

Maximum dose: Patients who do not experience sufficient pain relief following 2 to 4 weeks of treatment with 300 mg/day and who are able to tolerate pregabalin, may be treated with up to 300 mg 2 times a day or 200 mg 3 times a day. Due to the dose-dependent adverse effects and the higher rate of treatment discontinuation due to adverse events, dosing above 300 mg/day should be reserved only for those patients who have ongoing pain and are tolerating 300 mg daily.

Usual Adult Dose for Epilepsy:

Initial dose: 75 mg 2 times a day or 50 mg 3 times a day

Doses of 150 mg to 600 mg/day have been shown to be effective as adjunctive therapy in the treatment of partial onset seizures. The total daily dose should be divided and given either 2 or 3 times a day.

Maximum dose: Based on individual patient response and tolerability, the dose may be increased to a maximum of 600 mg/day.

The efficacy of add-on pregabalin in patients taking gabapentin has not been evaluated in controlled trials. Therefore, dosing recommendations for the use of pregabalin with gabapentin cannot be offered.

Usual Adult Dose for Fibromyalgia:

Initial dose: 75 mg two times a day (150 mg/day)

The dose may be increased to 150 mg two times a day (300 mg/day) within one week based on efficacy and tolerability.

Patients who do not experience sufficient benefit with 300 mg/day may be further increased to 225 mg two times a day (450 mg/day).

Recommended dose: 300 to 450 mg/day

Although pregabalin was also studied at 600 mg/day, there is no evidence that this dose confers additional benefit and this dose was less well tolerated. In view of the dose-dependent adverse reactions, treatment with doses above 450 mg/day is not recommended.

Usual Adult Dose for Neuropathic Pain:

For neuropathic pain associated with spinal cord injury:

Initial dose: 75 mg 2 times a day

The dose may be increased to 150 mg 2 times a day within 1 week based on efficacy and tolerability.

Doses of 150 mg to 600 mg/day have been shown to be effective as adjunctive therapy in the treatment of neuropathic pain associated with spinal cord injury. The total daily dose should be divided.

Maximum dose: Patients who do not experience sufficient pain relief following 2 to 3 weeks of treatment with 150 mg 2 times a day and who are able to tolerate pregabalin, may be treated with up to 300 mg 2 times a day. Because pregabalin is eliminated primarily by renal excretion, the dose should be adjusted in patients with reduced renal function.

What other drugs will affect pregabalin?

Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for depression or anxiety can add to dizziness or sleepiness caused by pregabalin. Tell your doctor if you regularly use any of these medicines, or any other seizure medication.

Tell your doctor about all other medicines you use, especially:

  • rosiglitazone (Avandia, Avandamet, Avandaryl); or

  • heart or blood pressure medication such as benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others.

This list is not complete and other drugs may interact with pregabalin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about pregabalin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.02. Revision Date: 2012-08-28, 2:05:58 PM.

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