Pregabalin

It 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.

Indications

-Neuropathic pain associated with diabetic peripheral neuropathy -Postherpetic neuralgia -Adjunctive therapy for adult patients with partial-onset seizures -Fibromyalgia -Generalized anxiety disorder

Dosage

-Neuropathic Pain: Start with 75 mg twice daily. May increase to 150 mg twice daily within one week based on efficacy and tolerability. Maximum dose is 300 mg twice daily. -Epilepsy: Start with 75 mg twice daily. May increase to 150 mg twice daily. Maximum dose is 600 mg per day. -Fibromyalgia: Start with 75 mg twice daily. May increase to 150 mg twice daily. Maximum dose is 225 mg twice daily. -Generalized Anxiety Disorder: Start with 75 mg per day. May increase to 150 mg per day. Maximum dose is 600 mg per day.

Contra-Indications

Hypersensitivity to pregabalin or any of its components.

Special Precautions

-Use with caution in patients with renal impairment; dose adjustment may be necessary. -Monitor for signs of suicidal ideation and behavior. -Avoid abrupt discontinuation; taper off gradually to minimize withdrawal symptoms. -Use cautiously in patients with a history of substance abuse.

Side Effects

Dizziness, drowsiness, visual disturbance (including blurred vision, diplopia), ataxia, dysarthria, tremor, lethargy, memory impairment, euphoria, weight gain, constipation, dry mouth, confusion, agitation.

Drug Interactions

-Enhanced central nervous system effects when used with alcohol or other CNS depressants. -Possible additive effects when taken with medications that can cause weight gain.