Classifications: analgesic; anticonvulsant; anxiolytic; gaba-analog; Therapeutic: anticonvulsant; antianxiety; analgesic
Pregnancy Category: C
Controlled Substance: Schedule V
25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, 300 mg capsules
Pregabalin is an analog of gamma-aminobutyric acid (GABA). It is structurally related to gabapentin, but shows greater potency
in pain and seizure disorders (310 times greater). The exact mechanism of action of pregabalin as an antiseizure agent
is unknown. It increases neuronal GABA levels and reduces calcium currents in the calcium channels of neurons; this may
account for its control of pain and anxiety.
Has analgesic, anti-anxiety, and anticonvulsant properties.
Management of neuropathic pain associated with diabetic peripheral neuropathy, adjunctive therapy for adult patients with
partial-onset seizures, management of postherpetic neuralgia, fibromyalgia.
Treatment of generalized anxiety disorders, treatment of social anxiety disorder, treatment of moderate pain.
Hypersensitivity to pregabalin or gabapentin; alcohol; pregnancy (category C); lactation. Safety and efficacy in children
<12 y have not been established.
Renal impairment or failure, hemodialysis; elderly; congestive heart failure, NYHA (Class III or IV) cardiac status.
Route & Dosage
|Neuropathic Pain (Diabetic Peripheral Neuropathy)
Adult: PO 50100 mg t.i.d.
Adult: PO Initial dose ≤75 mg b.i.d or 50 mg t.i.d; may increase to 300 mg b.i.d. or
200 mg t.i.d.
Adult: PO 75 mg b.i.d., may increase up to 150 b.i.d. within first week, then up to 225 b.i.d. (max dose: 450 mg/d)
Adult: PO Initial dose 75 mg b.i.d. or 50 mg t.i.d; may increase to 150300 mg b.i.d. or 100200 mg t.i.d.
Clcr 3060 mL/min: 75300 mg/d given in 2 or 3 divided doses; 1530 mL/min: 25150 mg/d given in 1 or 2 divided
doses; <15 mL/min: 2575 mg once daily
Hemodialysis: Dose based on renal function, give supplemental dose
- Dosage reduction is required with renal dysfunction.
- Drug should not be abruptly stopped; discontinue by tapering over a minimum of 1 wk.
- Give a supplemental dose immediately following dialysis.
- Store at 15°30° C (59° 86° F).
Adverse Effects (≥1%) Body as a Whole: Accidental injury,
flu syndrome, pain. CNS:
Abnormal gait, amnesia, ataxia,
euphoria, headache, incoordination, myoclonus, nervousness, neuropathy
speech disorder, abnormal thinking, tremor, twitching, vertigo. CV:
Chest pain. GI: Constipation
, dry mouth, flatulence, increased appetite, vomiting. GU:
Urinary incontinence. Metabolic/Nutritional:
Edema, facial edema, hypoglycemia
, peripheral edema, weight gain. Musculoskeletal:
Back pain, myasthenia. Respiratory: Bronchitis
, dyspnea. Special Senses:
Abnormal vision, blurry vision, diplopia.
Concomitant use with thiazolidinediones
may exacerbate weight gain and fluid retention.
90% bioavailability. Peak:
1.5 h. Metabolism:
Primarily in the urine. Half-Life:
Assessment & Drug Effects
- Monitor for weight gain, peripheral edema, and S&S of heart failure, especially with concurrent thiazolidinedione (e.g.,
- Lab tests: Baseline and periodic kidney function tests; periodic platelet counts; CPK if rhabdomyolysis is suspected.
- Monitor diabetics for increased incidences of hypoglycemia.
- Withhold drug and notify physician if rhabdomyolysis is suspected.
- Supervise ambulation especially when other CNS drugs are used concurrently.
Patient & Family Education
- Do not drive or engage in potentially hazardous activities until response to drug is known.
- Report any of the following to a health care provider: changes in vision (i.e., blurred vision); dizziness and incoordination;
unexplained muscle pain, weakness, or tenderness; weight gain and swelling of the extremities.
- Avoid alcohol consumption while taking this drug.
- Inform your physician if you plan to become pregnant or father a child.