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GENERIC NAME: Pregabalin
BRAND NAME: Lyrica
DRUG CLASS AND MECHANISM: Pregabalin is an oral medication that is chemically related to gabapentin. It is used for treating pain caused by neurologic diseases such as neuropathic pain, postherpetic neuralgia as well as seizures. It also is used for treating fibromyalgia. The mechanism of action of pregabalin is unknown. Pregabalin binds to calcium channels on nerves and may modify the release of neurotransmitters that nerves use to communicate with each other. Reducing communication between nerves may contribute to pregabalin's effect on pain and seizures. Pregabalin was approved by the FDA in June, 2005.
PREPARATIONS: Capsules; 25, 50, 75, 100, 150, 200, 225, and 300 mg
STORAGE: Pregabalin should be stored at room temperature, between 15-30°C (59-86°F).
PRESCRIBED FOR: Pregabalin is used for neuropathic pain associated with diabetic peripheral neuropathy; postherpetic neuralgia; and in combination with other drugs to treat partial onset seizures in adults. It also is used for treating fibromyalgia.
DOSING: Pregabalin may be administered with or without food. The initial dose for neuropathic pain is 50 mg three times a day (150 mg/d). The dose may be increased to a maximum dose of 100 mg 3 times daily (300 mg/d) after one week.
The recommended starting dose for postherpetic neuralgia is 75 mg twice daily or 50 mg three times daily. The dose may be increased to 100 mg 3 times daily (300 mg/d) after one week. If pain relief is inadequate after 2-4 weeks of treatment at 300 mg/d, the dose may be increased to 300 mg twice daily or 200 mg three times daily. Doses greater than 300 mg cause more side effects.
The recommended dose for treating seizures is 150-600 mg/d divided into 2 or 3 doses.
DRUG INTERACTIONS: Alcohol and drugs that cause sedation may increase the sedative effects of pregabalin.
PREGNANCY: There are no adequate studies of pregabalin in pregnant women.
NURSING MOTHERS: It is not known whether pregabalin is excreted in human breast milk.
SIDE EFFECTS: The most common side effects of pregabalin are dizziness, drowsiness, dry mouth, edema (accumulation of fluid), blurred vision, weight gain, and difficulty concentrating. Other side effects include peripheral edema, reduced blood platelet counts, and increased blood creatinine kinase levels. Increased creatinine kinase could be a sign of muscle injury, and in clinical trials three patients experienced rhabdomyolysis (severe muscle injury). Therefore, patients should report unexplained muscle pain, tenderness or weakness to their doctors, especially if associated with fever and malaise (reduced well-being). | 
