Pregabalin (Oral)

Predominantly used to treat epilepsy, Pregabalin can also be prescribed to treat nerve pain and/or fibromyalgia.

Overview

As an anticonvulsant medicine, Pregabalin can be used to control seizures associated with epilepsy. Although the medication does not cure the condition, it can help to reduce the frequency of seizures when it is taken on an on-going basis.

Chemically, Pregabalin is similar to the neurotransmitter gamma aminobutyric acid (GABA). Although the medication works differently to GABA, both are related to the firing of nerve cells in the brain. Generally, GABA occurs naturally and helps to prevent nerve cells from firing too quickly. When seizures occur, however, brain cells work more quickly than they need to.

By taking Pregabalin, patients can avoid the seizures associated with conditions, such as epilepsy. When the brain's cells begin to fire too quickly and a seizure starts, Pregabalin works to reduce the rate at which the brain cells are firing and, therefore, prevents the seizure from continuing.

Although Pregabalin can be extremely effective in reducing the frequency of seizures, it is not normally used in isolation. Most patients with epilepsy will be given a range of medications to control their symptoms. When used in conjunction with these, Pregabalin can be effective in the management and treatment of the condition.

As well as being used to control epileptic seizures, Pregabalin can be used to control nerve pain or postherpetic neuralgia. Nerve pain can take various forms but patients often describe the pain as intense shooting, stabbing or burning pains. Notoriously difficult to treat with traditional pain medications, Pregabalin can offer to relieve to patients who are suffering from nerve pain.

As Pregabalin binds to the nerves and slows down signals from the brain, it is believed that the medicine also limits the ability of the nerves to send pain signals. In addition to this, its effect on brain chemicals means that fewer pain signals are sent from the brain to the nervous system.

Whilst Pregabalin can be used to treat various types of nerve pain, it can also be used to reduce the pain associated with postherpetic neuralgia. Normally occurring as a complication caused by the shingles virus, patients with postherpetic neuralgia experience burning pain due to the impact the virus has had on their nerve fibers. By reducing the ability of the nerves to send pain signals and reducing the pain signals sent from the brain, Pregabalin can reduce the symptoms of postherpetic neuralgia in the same way it can be used to treat nerve pain.

For patients with fibromyalgia, Pregabalin can also provide significant relief from symptoms. Characterized by chronic pain and muscle stiffness, Pregabalin has been shown to reduce many of the pain symptoms associated with the condition. Although the cause of fibromyalgia is still unknown, it is believed that changes to the nerves cause the nerve cells to send signals too quickly. Due to this, patients can be overstimulated easily and may experience pain on a regular or constant basis.

By reducing the number of nerve signals sent, however, Pregabalin can effectively calm the over-sensitive nerves and prevent pain from occurring. With many patients struggling to find effective treatments for fibromyalgia, Pregabalin may provide a new first-choice treatment for the condition.

As Pregabalin can be used to treat various conditions, it is a widely-used medication. Whilst it is not typically used for pain management when other pain medications are effective, it can provide pain relief from conditions which have not responded to other treatments. Furthermore, Pregabalin is extremely useful in the treatment and management of epilepsy-related seizures. When used alongside other medicines, Pregabalin can significantly reduce the number of seizures the patient experiences.

Conditions Treated

Type Of Medicine

  • Anticonvulsant
  • Neuropathic pain agent

Side Effects

When taking Pregabalin, patients may experience some side-effects. Although these are not uncommon, they may be reduced once the patient has been taking the medicine for some time. Unless serious, the following side-effects may not need medical attention:

  • Accidental injury
  • Tingling, burning, numbness or pain in the arms, hands, legs or feet
  • Swelling or bloating of the hands, arms lower legs, face or feet
  • Change in balance or walking
  • Blurred vision
  • Delusions
  • Clumsiness
  • Dementia
  • Confusion
  • Dry mouth
  • Difficulty having a bowel movement (stool)
  • Fever
  • Difficulty speaking
  • Headache
  • Double vision
  • Hoarseness
  • Loss of memory
  • Increased appetite
  • Pain in lower back or side
  • Lack of coordination
  • Difficulty or painful urination
  • Rapid weight gain
  • Problems with memory
  • Tingling of the feet or hands
  • Seeing double
  • Swelling
  • Sensation of pins and needles
  • Stabbing pain
  • Unsteady walk and shakiness
  • Trembling or other problems with coordination or muscle control
  • Unusual drowsiness or sleepiness
  • Anxiety
  • Unusual weight loss or gain
  • Full feeling or bloating
  • Chest pain
  • Itching, crawling, numbness, tingling, prickling, burning or "pins and needles" feelings
  • Pale, cool skin
  • Cold sweats
  • Change of decrease in vision
  • Coma
  • Depression
  • Cough producing mucus
  • Increased hunger
  • Excess gas or air in the intestines or stomach
  • General feeling of illness or discomfort
  • Eye disorder
  • Pain in joints
  • Unusual or false sense of well-being
  • Loss of appetite
  • Muscle pains and aches
  • Loss of bladder control
  • Muscle jerking or twitching
  • Loss of energy or strength
  • Nausea
  • Muscle weakness
  • Nervousness
  • Vomiting
  • Nightmares
  • Uncontrolled eye movements
  • Noisy breathing
  • Twitching
  • Pain
  • Difficulty sleeping
  • Passing gas
  • Slurred speech
  • Rhythmic movements of the muscles
  • Sweating
  • Runny nose
  • Shivering
  • Seizures

There are, however, additional side-effects which may occur when patients are taking Pregabalin. If patients experience any of the following adverse effects, they should seek medical help:

  • Labored or difficult breathing
  • Tightness in chest
  • Shortness of breath
  • Loosening, peeling or blistering of the skin
  • Diarrhea
  • Chills
  • Difficulty swallowing
  • Hives
  • Cough
  • Dizziness
  • Itching
  • Fast heartbeat
  • White spots, ulcers or sores on the lips or in the mouth
  • Muscle or joint pain
  • Swelling or puffiness of the eyelids lips, tongue, face or around the eyes
  • Irritated, red eyes
  • Unusual weakness or tiredness
  • Red skin lesions, sometimes with a purple center
  • Sore throat
  • Rash on the skin

Although the above symptoms do not commonly affect patients, they do warrant medical attention when they do occur. In addition to this, patients should seek medical assistance if they experience any side-effects which are not listed above.

Dosage

When taking Pregabalin, or any medication, patients should follow their physician's instructions. Generally, the patient's dose will depend on the condition they're being treated for, as well as the severity of their symptoms and their medical history.

In most cases, patients taking Pregabalin for nerve pain associated with diabetes will be advised to take 50mg three times per day. If necessary, the patient's dose can be increased if their symptoms persist but patients are not normally instructed to take more than 300mg of Pregabalin per day when being treated for this condition.

If patients are given Pregabalin for treating nerve pain caused by a spinal injury, however, the standard dose is normally 75mg of Pregabalin, twice per day. If the patient is still experiencing pain on this dose of medication, they may be advised to take more Pregabalin. However, patients are not normally instructed to take more than 600mg of Pregabalin when they are being treated for nerve pain associated with a spinal injury.

If patients are prescribed Pregabalin for the prevention of epileptic seizures, however, they may be advised to take 75mg twice per day or 50mg three times per day. If symptoms persist, patients may be instructed to take a higher dose, up to a maximum of 600mg per day.

Alternatively, patients taking Pregabalin to treat fibromyalgia are commonly advised to take 75mg of Pregabalin twice per day. If this does not control the patient's symptoms adequately, their dose may be increased. However, patients are not normally advised to take more than 450mg of Pregabalin per day when they are being treated for fibromyalgia.

When taking Pregabalin for postherpetic neuralgia, patients may be prescribed 75-150mg twice per day or 50-100mg three times per day. If this is not enough to control the patient's symptoms, their dose can be increased but more than 600mg of Pregabalin per day is not normally recommended.

Although these are standard dosing regimes for treatment with Pregabalin, every patient will be assessed individually and should, therefore, adhere to their doctor's instructions. Generally, Pregabalin can be taken with or without food but patients may be advised to take their medication at a certain time of the day.

If patients are taking Pregabalin in liquid form, as opposed to a capsule, they should use a designated medicine spoon, oral syringe or measuring cup to calculate the right amount of medication. Using household spoons could prevent the right dose of medication from being delivered and is not recommended.

If patients miss a dose of Pregabalin, they should take it as soon as they remember to do so. However, if their next dose of medicine is almost due, patients should skip the missed dose completely and take their next dose as normal. It is not appropriate to take a double dose of Pregabalin, even if a previous dose has been missed.

Although patients should be given specific dosage instructions when their medicine is prescribed to them, they should always seek help if they are unsure how to take Pregabalin. Furthermore, patients can obtain advice from their doctor or pharmacist if they have missed a dose of Pregabalin and are unsure how to continue with treatment.

Potential Drug Interactions

As some medications can interact with others, it may not be appropriate for patients to take Pregabalin alongside some other medicines. Generally, Pregabalin will not be prescribed if the patient is also taking:

  • Orlistat
  • Calcifediol

However, if physicians believe that the benefits of taking both medicines outweigh any potential risks, they may prescribe Pregabalin alongside these medications. If so, the patient's dose may be altered in order to reflect their existing medication intake.

Patients should also be aware that prescription drugs can sometimes interact with over-the-counter medicines, supplements and vitamins. If patients are taking any of these substances, they should inform their doctor before they take Pregabalin. Similarly, patients should seek medical advice before using any of these supplements once they have started taking Pregabalin.

Warnings

If the patient has any existing medical conditions, they should discuss them with their doctor before using Pregabalin. In some cases, existing medical conditions may affect treatment with this medication. These conditions may include:

Currently, there have not been sufficient studies into the effects of Pregabalin on pediatric patients. Due to this, younger patients may not be prescribed Pregabalin. However, if doctors do prescribe this medicine to pediatric patients, they are likely to prescribe a low starting dose so that the patient's reaction to the drug can be monitored.

Whilst Pregabalin can be prescribed to geriatric patients, they may be more likely to suffer from the side-effects associated with the medicine. In addition to this, age-related health problems, such as kidney, heart and/or liver disease, may affect the use of Pregabalin. As these conditions can reduce the rate at which medicines can be processed by the body, older patients may be prescribed a relatively low dose of Pregabalin.

Studies have not yet shown whether Pregabalin is safe to take when pregnant. Due to this, patients who are pregnant may not be prescribed this medication. If the patient becomes pregnant when taking Pregabalin, they should contact their physician for advice.

If patients are breastfeeding, it may not be safe for them to take Pregabalin. As medications can be passed to the infant via breastfeeding, Pregabalin could have a potentially harmful effect on the infant. Due to this, patients are generally advised not to breastfeed whilst taking Pregabalin.

In rare cases, patients can experience angioedema when taking Pregabalin. This is a severe allergic reaction and is characterized by the following symptoms:

  • Blisters, redness or a rash on the skin
  • Difficulty breathing
  • Difficulty swallowing
  • Swelling of the eyes, lips, mouth, tongue, gums and/or face

If patients experience any of these symptoms, it should be treated as a medical emergency and they should obtain urgent medical assistance.

Furthermore, patients should seek medical help if they experience muscle tenderness, pain or weakness when taking Pregabalin, particularly if they also have a fever. These symptoms may indicate that the patient is suffering from a muscle problem known as myopathy.

Taking Pregabalin can cause some patients to experience behavioral changes, irritability and/or agitation. In some cases, patients may experience suicidal thoughts or depression. If so, medical help should be sought immediately.

When taking Pregabalin, patients may experience blurred vision, clumsiness, dizziness, double vision, difficulty thinking and/or unsteadiness. Patients should monitor their reaction to the medication before driving, operating machinery or carrying out any tasks which require their full attention.

Pregabalin will add to the effects of alcohol and other central nervous system depressants, such as hay fever, allergy or cold medicines, tranquilizers, narcotics, sedatives, anticonvulsants, anesthetics and muscle relaxants. Patients should seek medical advice before taking any of these medications alongside Pregabalin.

As Pregabalin can add to the effects of anesthetic, patients should notify the relevant healthcare practitioners if they are due to undergo any surgical procedures, including dental work.

Pregabalin may cause patients to gain weight and/or retain fluid. This may be troublesome for patients with patients with heart failure and they should seek medical help if they experience these side-effects.

Patients should not suddenly stop taking Pregabalin, unless they are advised to do by their doctor. Stopping this medication suddenly could cause withdrawal symptoms, such as, nausea, vomiting, headaches, dizziness, diarrhea, difficulty sleeping, tingling and/or nightmares.

Storage

When storing Pregabalin at home, patients should follow the manufacturer's instructions and keep their medicine out of reach of children and/or pets. In most cases, Pregabalin capsules can be kept at room temperature but they should be kept away from direct light, heat and moisture.

When disposing of Pregabalin, patients should contact their physician's office or pharmacist and use a dedicated medicine disposal method.

Summary

Although Pregabalin is associated with a number of side-effects, these do not affect every patient. Furthermore, many of the side-effects associated with the medication occur for a limited period of time and diminish as the patient gets used to the drug.

Providing the medicine is tolerated, Pregabalin can reduce the frequency of seizures in epileptic patients and provide significant relief from nerve pain, postherpetic neuralgia and fibromyalgia. Due to this, Pregabalin has been recognized for its usefulness in controlling symptoms which are notoriously difficult to treat and for facilitating pain management when other medications have failed to do so.