Lyrica (pregabalin)

LYRICA (pregabalin) – a gabanergic antiepileptic drug commonly used to treat various neuropathic pain disorders. LYRICA (pregabalin) binds with high affinity to the alpha2-delta site (an auxiliary subunit of voltage-gated calcium channels) in central nervous system tissues. Although the mechanism of action of pregabalin has not been fully elucidated, research with compounds structurally related to pregabalin (such as gabapentin) suggest that binding to the alpha2-delta subunit may be involved in pregabalin’s anti-pain and antiseizure effects.

FDA approved uses: Lyrica is indicated for the treatment of: Neuropathic pain associated with diabetic peripheral neuropathy; Postherpetic neuralgia (PHN); Adjunctive therapy for adult patients with partial onset seizures; Fibromyalgia; Neuropathic pain associated with spinal cord injury.

Available dosage forms: Capsules: 25, 50, 75, 100, 150, 200, 225, and 300 mg.

Usual dosage: The following is the recommended dosing for Lyrica – DPN Pain: 3 divided doses per day; maximum of 300 mg/day within 1 week. PHN: 2 or 3 divided doses per day; 300 mg/day within 1 week; Maximum dose of 600 mg/day. Adjunctive Therapy for Adult Patients with Partial Onset Seizures: 2 or 3 divided doses per day; Maximum dose of 600 mg/day. Fibromyalgia: 2 divided doses per day; 300 mg/day within 1 week. Maximum dose of 450 mg/day. Neuropathic Pain Associated with Spinal Cord Injury: 2 divided doses per day; 300 mg/day within 1 week. Maximum dose of 600 mg/day.

Contraindications: Known hypersensitivity to pregabalin or any of its components.

Special warnings: Angioedema and hypersensitivity reactions may occur. Discontinue Lyrica immediately in these cases. Increased seizure frequency may occur with abrupt discontinuation. May cause dizziness and somnolence and impair patients’ ability to drive or operate machinery. May cause peripheral edema. Use caution when administering Lyrica to patients treated with thiazolidinedione antidiabetic agents.

Adverse reactions (side effects) of these medications: The most common side effects of Lyrica include dizziness, somnolence, dry mouth, edema, blurred vision, weight gain and thinking abnormal (primarily difficulty with concentration/attention). Other adverse reactions seen in clinical trials or post-marketing include: asthenia, back pain, chest pain, face edema, constipation, flatulence, peripheral edema, hypoglycemia, neuropathy, ataxia, confusion, euphoria, incoordination, tremor, abnormal gait, amnesia, nervousness, dyspnea and abnormal or blurry vision .

Common drug interactions: manufacturer states that additive effects on cognition and gross motor functioning were seen when co-administered with oxycodone, lorazepam or alcohol.

Special instructions for patients: Take Lyrica exactly as prescribed by physician. LYRICA may cause angioedema, with swelling of the face, mouth (lip, gum, tongue) and neck (larynx and pharynx) that can lead to life-threatening respiratory compromise. Discontinue LYRICA and immediately seek medical care if these symptoms are experienced. AEDs, including LYRICA, may increase the risk of suicidal thoughts and behavior and patients should be alert for the emergence or worsening of symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts, behavior, or thoughts about self-harm. Report behaviors of concern immediately to healthcare providers. Do not drive, operate complex machinery, or engage in other hazardous activities until you have gained sufficient experience on LYRICA to gauge whether or not it affects your mental, visual, and/or motor performance adversely. Consult official Medication Guide for details on all of the warnings and precautions for using this medication.

Full prescribing information may be found at the manufacturer‘s official website Lyrica.com or at the U.S. Food and Drug Administration’s website at Lyrica Info at Drugs@FDA

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