Pregabalin: indications, uses, precautions, side effects

Pregabalin is a drug (brand name Lyricaยฎ) developed by Pfizer in the United States, and has the effect of suppressing excessive excitability in the brain and relieving nervous pain. It is used to treat seizures in patients with epilepsy, to treat pain caused by nerve damage or abnormal nerve function, and chronic pain in muscles, joints, ligaments, and tendons. Withdrawal symptoms may appear if the medication is suddenly stopped, so if the medication is stopped, the dose should be reduced slowly.

How does pregabalin work?

The substances involved in the transmission of nerve signals in the brain and body functions are called neurotransmitters, which are largely divided into excitatory neurotransmitters and inhibitory neurotransmitters. The excitatory neurotransmitter has an effect of stimulating the brain, and the inhibitory neurotransmitter has the effect of calming the brain or maintaining balance. When brain nerve cells cause temporary abnormalities and become excessively excited, brain function is temporarily paralyzed, causing loss of consciousness or seizures.

Pregabalin is a neuropathic drug used for the treatment of neuropathic pain and fibromyalgia, and is an anticonvulsant drug for treating seizures in patients with epilepsy. Structurally, it is similar to gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter of the central nervous system, but does not bind to gaba receptors. By inhibiting excitatory neurotransmitters and pain neurotransmitters, it suppresses excessive excitability in the brain and relieves neurogenic pain.

What are the effects of pregabalin?


It is used as an adjuvant in the treatment of partial seizures in adults with epilepsy, and in the treatment of peripheral and central neuropathic pain and fibromyalgia in adults. In the case of sustained-release tablets (tablets made to release the ingredients slowly), they are only used in the treatment of peripheral neuropathic pain in adults. Products include Lyricaยฎ.

When and how to take pregabalin?

In the case of pregabalin capsules or tablets, the total daily dose is divided into twice a day and administered regardless of the time before and after food intake. In the case of sustained-release tablets, they are administered once a day after dinner, and should be swallowed whole without splitting them. Since it is mainly excreted by the kidneys, the dose should be adjusted for patients with decreased renal function. In the case of discontinuation of administration, it should be gradually discontinued at least one week apart.

Neuropathic pain

Starting with 150 mg per day, it can be increased to 300 mg per day after 7 days, and if necessary, it can be increased to 600 mg per day at intervals of 7 days.

Epilepsy

Starting with 150 mg per day, it can be increased to 300 mg per day after 7 days, and if necessary, it can be increased to 600 mg per day at intervals of 7 days.

Fibromyalgia

Starting with 150 mg per day, it can be increased to 300 mg per day within 7 days, and if necessary, it can be increased to 450 mg per day within an additional 7 days.

What are the precautions when taking pregabalin?


The risk of suicidal thoughts or suicidal behavior is increased in patients taking antiepileptic drugs including pregabalin, and the risk is also increased by the disease itself. Therefore, antiepileptic drug users and their guardians should carefully monitor the patient’s suicidal thoughts or suicidal behavior, the onset or worsening of depression, and abnormal changes in mood and behavior.

Diabetic patients who have recently gained weight due to the administration of pregabalin may need to adjust the dose of a hypoglycemic agent.

Hypersensitivity reactions including angioedema have been reported when pregabalin is administered. Therefore, if symptoms of angioedema such as edema on the face, mouth, and upper respiratory tract of the patient appear, the use should be stopped immediately.

When pregabalin is administered to elderly patients, the frequency of injuries associated with dizziness and drowsiness may increase, so the user should be careful until they become familiar with the effects.

When pregabalin is administered, temporary blurred vision or visual acuity may change, but if the drug is stopped, symptoms may disappear or improve.

After discontinuation of pregabalin treatment, withdrawal symptoms* such as insomnia, headache, nausea, anxiety, diarrhea, influenza-like syndrome, restlessness, depression, pain, seizures, hyperhidrosis, and dizziness were observed in some patients. It should be stopped slowly at intervals of at least one week.

Congestive heart failureโ€  has been reported in some patients taking pregabalin and should be administered with caution in patients at this risk.

Pregabalin may cause dizziness and drowsiness, so the user should be careful not to drive or manipulate complex machinery while taking pregabalin until he knows whether it affects these activities after taking it.

What are the side effects of pregabalin?

The main side effects that can occur when pregabalin is administered are as follows. Other detailed information can be found in the product manual or product-specific permission information. If side effects occur, notify a doctor, pharmacist, and other experts so that they can take appropriate measures.

Very common side effects (reported by more than 10% of users)

Dizziness, drowsiness, headache, etc.

Common side effects (reported by 1-10% of users)

  • Nervous system: attention disorder, memory disorder, balance disorder, ataxia (walking disorder, fall), paresthesia (disorientation disorder, irritability, blurred vision, overlapping appearance), sedation, tremor, speech disorder, etc.
  • Mental system: confusion, abnormal mood (depression, abnormal feelings of happiness), decreased libido, insomnia, etc.
  • Digestive system: vomiting, abdominal distention, constipation, dry mouth, etc.
  • Musculoskeletal system: joint pain, muscle cramps, back pain, limb pain, etc.
  • Others: swelling, weight gain, increased appetite, feeling of drunkenness, fatigue, nasopharyngitis, etc.

Rare side effects (reported by less than 1% of users)

Weight loss, loss of appetite, increase or decrease in blood sugar, hallucinations, agitation, increased libido, cognitive impairment, eye concussion, reflexes, fainting, arrhythmia, hypotension or high blood pressure, flushing, peripheral coldness, dyspnea, non-bleeding, cough, saliva Excessive secretion, reflux esophagitis, dysuria, urinary incontinence, fever, chills, sweating, weakness, thirst, etc.

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