Pregabalin
Pregabalin(中文: 普瑞巴林)is an anticonvulsant medication:
- Peripheral and central neuropathic pain
- Used as an adjunctive therapy for focal seizures with or without secondary generalization.
- Generalized anxiety disorder
Pronunciation[edit]
Pregabalin 150mg[edit]
Pregabalin 25mg[edit]
Pregabalin 50mg[edit]
Drug name[edit]
| Generic Name 藥名 | HA Code 藥物代碼 | Classification藥物分類 |
|---|---|---|
| Pregabalin Capsule 25mg | PREG15 | P1S1S3 |
| Pregabalin Capsule 75mg | PREG16 | P1S1S3 |
Mechanism of Action[edit]
Anticonvulsant medication. It inhibits the alpha 2-delta subunit of voltage-dependent calcium channels.
Dosage[edit]
| Epilepsy | By mouth
the initial oral dose is 25 mg twice daily, increased at weekly intervals in steps of 50 mg daily to 300 mg daily in 2-3 divided doses, increased further if necessary after 7 days to max. 600 mg daily in 2-3 divided doses. |
|---|---|
| Neuropathic Pain | By mouth
initially 150 mg daily in 2-3 divided doses, increased if necessary after 3-7 days to 300 mg daily in 2-3 divided doses, increased further if necessary after 7 days to max. 600 mg daily in 2-3 divided doses. Alternatively, 300 mg 3 times daily on day 1, then increased according to response in steps of 300mg (in 3 divided doses) every 2-3 days up to max. 3.6 g daily. |
| Generalized anxiety disorder | By mouth
initially 150 mg daily in 2-3 divided doses, increased if necessary at weekly intervals in steps of 150 mg daily; max. 600 mg daily in 2-3 divided doses. As with other antiepileptics, withdrawal of prgabalin therapy or transition to or from another type of antiepileptic therapy should be made gradually to avoid precipitating an increase in seizure frequency. |
Side Effects[edit]
Adverse drug reactions associated with the use of pregabalin include:
| Very common (>10% of people with pregabalin ) | Dizziness, drowsiness |
| Common (1-10% of people with pregabalin) | Blurred vision, diplopia,
Increased appetite and subsequent weight gain Euphoria Confusion Memory impairment Tremor Vertigo Vomiting and flatulence
Erectile dysfunction Peripheral edema Ataxia |
| Infrequent (0.1 -1% of people with pregabalin) | Depression
Lethargy Agitation Hallucination Tachycardia Excessive salivation Hypoglycaemia Sweating Muscle cramp, myalgia Urinary incontinence, dysuria Thrombocytopenia |
| Rare (<0.1% of people with pregabalin ) | Blood disorders, anaemia, leucopenia
Neutropenia First degree heart block Pancreatitis Dysphagia Suicidal thoughts or behaviour |
When pregabalin is taken at high doses over a long period of time, addiction may occur.
Pharmacokinetics[edit]
| Oral bioavailability | Pregabalin is rapidly absorbed after oral doses. |
|---|---|
| Onset of action | Peak plasma concentrations occur within 1.5 hours.
Steady state is achieved after 1 to 2 days. |
| Metabolism | Pregabalin undergoes negligible metabolism. |
| Elimination half-life | Gabapentin is eliminated renally in the urine as unchanged drug.
The mean elimination half-life is 6.3 hours. Because of its short elimination half-life, pregabalin is administered 2 to 3 times per day to maintain therapeutic levels. Pregabalin is removed by haemodialysis. |
Drug Management[edit]
Monitoring[edit]
- recognize signs of blood, liver, or skin toxicity. Seek immediate medical attention if symptoms such as fever, sore throat, rash, blistering, mouth ulcers, bruising or bleeding develop.
- Patients with heart failure should be weighed regularly to detect fluid retention.
- Patients with pre-existing cardiac conduction disorders should be carefully monitored.
- changes in mood, the development or worsening depression, and/or any thoughts or behavior of suicide.
Drug interaction[edit]
No interactions have been demonstration in vivo.
Caution[edit]
- Avoid abrupt withdrawal
- Severe congestive heart failure
- Conditions that may precipitate encephalopathy
Renal impairment[edit]
Reduced doses according to creatinine clearance:
- If creatinine clearance 30 to 60 ml/minute: 75 mg daily and max. dose 300mg daily in 2 or 3 divided doses
- If creatinine clearance 15to 29 ml/minute: 25 mg to 50 mg daily; max. 150 mg daily in 1-2 divided doses
- If creatinine clearance less than 15 ml/minute: 25 mg daily; max. 75 mg once daily
- Haemodialysis patients should receive in addition to the daily dose a supplementary dose of 25 to 100 mg immediately after each 4-hour haemodialysis session
Pregnancy[edit]
Women of child-bearing potential should discuss with a specialist the impact of both epilepsy, and its treatment, on the outcome of pregnancy. There is an increased risk of teratogenicity associated with the use of antiepileptic drug (especially if used during the first trimester)
Breast-feeding[edit]
Use during breast feeding is not recommended.
Epilepsy and driving[edit]
Driving by patients with epilepsy is generally regulated. Also, antiepileptic drugs may produce CNS-related adverse effects, including dizziness and drowsiness, that could impair a patient’s ability to drive a vehicle or operate machinery, particularly during the initial stages of therapy.
FAQ[edit]
How should I take the tablet?[edit]
Take preferably with or after food.
What should I avoid while taking?[edit]
Avoid abruptly discontinue the medication.
What happen if I overdose?[edit]
Contact your primary care doctor. If emergency situation, call 999
What happen if I miss a dose?[edit]
Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
