Pregabalin half-life
Table of Contents
Pregabalin half-life
Pregabalin is an anti-epileptic drug, related to the anticonvulsants family, a very effective drug in controlling partial-onset seizures and in managing the neuropathic pain related to many conditions.
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Neuropathic pain is caused by a diseased or damaged nerve; it causes pain throughout the nerve.
To understand the effectiveness and potency of Pregabalin, we have to study how Pregabalin works, Pregabalin half-life, and Pregabalin elimination.
First, let us get introduced to the detailed uses of Pregabalin:
- Neuropathic pain happens to diabetic patients
- Neuropathic pain happens after a spinal cord injury
- Neuralgia occurs after the infection with herpes zoster virus
- Pregabalin is the first approved drug in treating fibromyalgia (a chronic condition causing pain and tenderness throughout the body)
- It is also used as adjunctive therapy in treating partial-onset seizures even in children 1-month-old and older
How does Pregabalin work?
Pregabalin alters the way something called GABA (gamma-aminobutyric acid) neurotransmitters communicate, they are some kind of neurotransmitters found in the brain, when being altered, it affects the nervous system and cures the medical condition.
They help reduce the pain signals responsible for causing nerve pain and also control the impulses causing seizures reducing them.
Dosage and administration:
Pregabalin is available in the form of capsules, extended-release tablets, and oral solutions having many concentrations available.
The dose is determined based on the medical condition, age, and weight of the patient, and the response to the treatment.
You have to take the drug exactly as prescribed by your physician, to ensure the maximum benefit from it, and the least side effects.
Read the medication guide carefully before taking Pregabalin.
If you have any inquiries or questions, talk to your health care provider first.
The physician prescribes the lowest effective dose and increases it as needed according to the response and control of the medical condition taken for.
You have to take it at the recommended times to ensure a constant level of the drug.
Food doesn’t affect the absorption of Pregabalin, so it can be taken either with or without food.
Inform your doctor about new or worsening symptoms.
What if you missed a dose?
Take it as soon as possible.
If it is the time for the next dose, don’t take it to not suffer from overdose symptoms.
What if you overdosed?
Contact your physician at once if you feel symptoms or not.
Pregabalin is not a drug to be stopped at once, the dose should be decreased gradually, or else you will suffer from withdrawal symptoms.
Withdrawal symptoms:
- Headache
- Anxiety
- Confusion
- Agitation
- Sweating
- Rapid heartbeats
- Seizures
- Difficulties in sleeping
- Mood or behavioral changes
- Depression
- Suicidal thoughts
- Nausea
- Diarrhea
If you suffered from any of the above symptoms, seek medical attention immediately.
What is the Pregabalin half-life?
Half-time is the time taken for any drug to be reduced to half of its strength after taking the last dose.
Pregabalin half-life is about six hours.
Elimination:
Pregabalin gets eliminated quickly through the kidneys; it stays in your body for approximately 33 hours, depending on several factors.
Factors affecting Pregabalin half-time and elimination:
- Kidney functions
- Age
- Body mass
- Hydration (If the body have enough water in it)
- Urinary PH (Measure of the degree of acidity or basicity of the urine)
- The dose of the drug
- Duration of treatment
You have also to inform your physician about your medical history and your habits as they may also affect pregabalin half-life and how long it stays in the body.
How long does Pregabalin stay in urine, blood, and hair?
Pregabalin stays in urine for a few days depending on the dose of the drug.
It stays in the blood for only 2 days after the last dose.
Hair surpasses both of them, as Pregabalin may stay in the hair around 90 days.
Side effects:
Common side effects
- Drowsiness
- Dizziness
- Dry mouth
- Constipation
- Concentrating problems
- Weight gain
Serious side effects
- Blurred vision
- Unusual bruising or bleeding
- Unsteadiness
- Confusion
- Muscle pain
- Muscle weakness (especially if you suffer from fever or tiredness)
- Swelling of legs, feet, and hands
- Kidney problems
- Suicidal thoughts or behaviors
- Depression
Get medical help immediately if you suffer from shallow or slow breathing.
Before taking Pregabalin, you have to tell your doctor about:
- Heart problems
- Kidney problems
- Allergic reactions to Pregabalin or other drugs
- Any history of substance use
- Alcoholism
- Breathing problems
Precautions:
- Pregabalin can cause serious allergic reactions, take care of any signs of hives, rash, blisters, or swelling of any parts of the body
- You have your doctor about taking Pregabalin before having surgery or dental procedure
- Elders are more susceptible to suffer from drowsiness, dizziness, unsteadiness, confusion, and slow breathing
If you have any of the mentioned conditions, talk to your doctor about Pregabalin, and if it is suitable for your medical condition.
Discuss the dosage, side effects, and precautions of the drug before taking it.
Take care of the storage conditions and temperature.
Pregabalin Overdose
Table of Contents
Pregabalin Overdose
Pregabalin Overdose
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Gabapentinoids, specially Pregabalin, elevate the risks of injuries, suicidal behavior, overdoses, and accidents. These risks are particularly high for teens and young adults.
The increased risk to young people expected to be because they are more likely to have Pregabalin with alcohol or other drugs.
Also, younger people may be more vulnerable to the emotional and psychological side effects which can be part of Pregabalin titration and withdrawal.
Let’s recognize Pregabalin dosage first to understand the importance of the accurate following of the prescribed dosage by the health care provider, to avoid the risks of Pregabalin overdose.
Pregabalin dosage:
Your doctor will determine the dose suitable for your condition. You should follow your doctor’s instructions carefully and use Pregabalin exactly as prescribed otherwise you may experience risks of Pregabalin overdose.
The recommended dose is determined according to the patient’s kidney function and the medical condition treated.
For the oral forms (capsules or Liquid form):
the starting dose recommended is 150 mg per day in divided doses. The doctor will recommend increasing the dose gradually. Depending on the patient’s condition, the maximum dose could reach 300 mg per day, 450 mg per day, or 600 mg per day.
For long-acting capsules:
- The initial dose for neuropathic pain that happens with diabetes is 165 mg per day and could be increased to a maximum of 330 mg dose per day.
- The initial dose for the painful rash that occurs after herpes zoster infection is 165 mg per day and gradually increased to a maximum of 660 mg dose per day.
Pregabalin Overdose:
- Prescriptions for Pregabalin increased obviously in the latest decades as its use expanded for a range of clinical conditions outside epilepsy to treat anxiety, insomnia, neuropathic pain, fibromyalgia, and other psychiatric and mental issues. Also, Pregabalin is used increasingly in the black market.
- Many pharmacovigilance databases have warned for potential abuse liability and overdose fatalities related to Pregabalin.
- Researchers have noticed an increase in overdoses in England as a result of Pregabalin misuse.
- Researchers of public health and epidemiology concluded that the number of overdose deaths involving the combination of Pregabalin and opioids has increased substantially.
- Hence, health care professionals should be aware when prescribing Pregabalin.
- If you exceed the prescribed Pregabalin dose for you by your doctor call the local poison control center immediately or ask for emergency medical attention.
Poison control center:
The majority of medications have side effects that if the patient experienced an overdose of the drug these side effects may be life-threatening.
The poison centers are specialized units that help in the prevention of, diagnosis, and management of poisoning.
Some poisons centers may include toxicology laboratories and clinical treatment units.
Databases are available and saved by poison centers including databases of drug formulations and toxicological databases. These data help reduce the incidence of poisoning.
Pregabalin Addiction:
- When Pregabalin was first licensed to treat other conditions such as neuropathy pain, fibromyalgia, anxiety disorders, and neuralgia It was thought to be less addictive than benzodiazepines and a better alternative to highly addictive opiate-based painkillers. However, over years it became obvious that Pregabalin abuse is more common and can cause dependence and addiction.
- Tolerance and dependence of Pregabalin develop over time and with frequent use. Withdrawal of Pregabalin abuse may lead to seizures or severe psychological reactions.
Withdrawal symptoms are:
- Headache
- Anxiety
- Insomnia
- Nausea
- diarrhea
- Sweating
The advisory council on the misuse of drugs reported a 350% elevation in the prescribing of Pregabalin in the UK from 2007 to 2012.
Pregabalin Precautions:
Pregabalin may cause suicidal tendencies in a very small number of patients. If you notice any of these symptoms call your health care provider at once:
- Suicidal thoughts
- Depression new or elevated
- Anxiety new or elevated
- Restlessness
- Pain attacks
- Angry, aggressive, or violent behavior
- Insomnia
- Dangerous impulses
- Hyperactivity and too much talking
- Unusual behavior or mood changing
If you have suicidal actions do not stop Pregabalin suddenly you should call your doctor first as it may cause serious problems
Pregabalin may cause other serious side effects like:
Swelling of hands legs and feet: which could be a serious problem for patients with heart diseases.
Dizziness and insomnia: Do not perform dangerous activities work with hard machines or drive a car.
Changes in eyesight: Like blurred vision, call your doctor for advice.
Muscle pain weakness or soreness: If you have a fever or feel sick, call your doctor right away.
Euphoria (feeling extreme happiness laugh or joy).
Weight gain: It can be a serious problem for diabetic patients or patients with heart diseases.
– Do not take Pregabalin if you notice any allergic reactions.
– Do not drink alcohol while using Pregabalin.
Difference between gabapentin and pregabalin
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Difference between gabapentin and pregabalin
A lot of people get confused about the difference between gabapentin and pregabalin and always ask about how to differentiate between them. We will discuss this in more detail here.
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Pregabalin and gabapentin are two drugs from the same family, they are antiepileptic medications, and both are used for treating neuropathic pain associated with spinal cord injury, herpes zoster. There are similar in several side effects like Drowsiness, Dizziness, Vision problems, Tremors, Loss of balance or coordination, but gabapentin can cause more side effects other than those with pregabalin like:
- Difficulty speaking
- Jerky movements
- Viral infections
- unusual eye movements
- Fever
pregabalin can cause side effects that gabapentin cannot do it like:
- Constipation
- Swelling (edema)
- Dry mouth
- Weight gain
- Breast enlargement
Both drugs can interact with the same drugs that cause CNS (central nervous system) sedation including opioids and alcohol. Gabapentin may also interact with other drugs used for pain like nonsteroidal anti-inflammatory drugs (NSAIDs).
How do they work?
There is no difference between gabapentin and pregabalin in the mechanism of action of both drugs, they are similar in structure to the inhibitory neurotransmitter gamma-aminobutyric GABA, they are binding to GABA receptors and starting a cascade of reactions that result in anticonvulsant and analgesic effects.
What are the differences in the indications of pregabalin and gabapentin?
Pregabalin is used for:
- Treating fibromyalgia
- Neuropathic pain associated with diabetic peripheral neuropathy or herpes
- Spinal cord injury
- treating partial-onset seizures in adults as adjunctive therapy
Gabapentin can be used for different indications other than pregabalin; there are many non-FDA-approved uses for gabapentin. These include:
- Alcohol withdrawal
- Cocaine withdrawal
- Hiccups
- Restless leg syndrome
- Hyperhidrosis
- Headaches
- Diabetic neuropathy
- Hot flashes
- Fibromyalgia
What are the side effects of pregabalin and gabapentin?
All the antiepileptics include pregabalin and gabapentin increase the risk of suicidal thinking so doctors always weigh the benefits against this risk.
The most noticed side effect associate with pregabalin:
- double vision (diplopia)
- drowsiness
- dizziness
- dry mouth (xerostomia)
- edema (accumulation of fluid)
- fatigue (tiredness)
- blurred vision
- difficulty concentrating
- weight gain
- abnormal gait (ataxia)
- tremor
Other uncommon side effects include:
- heart failure
- constipation
- increased appetite
- nausea
- reduced blood platelet counts
- increased blood creatinine kinase levels.
- amnesia
- flatulence
- disorientation
- Myoclonus (involuntary movement).
- low blood pressure
- vomiting
Rhabdomyolysis
which is defined as severe muscle injury reported with the use of pregabalin and Increased creatinine kinase in the blood is considered a remarkable sign for it.
The most common side effects of gabapentin are similar to that of pregabalin, other adverse effects and serious side effects related to gabapentin only are:
- Weight gain
- Joint pain
- Motion sickness
- Blurred vision
- Viral infection
Withdrawal symptoms of pregabalin and gabapentin
Both of them are not opioid narcotic but they have not controlled substances but abrupt discontinuation of them results in withdrawal symptoms which are slightly different from each other
Withdrawal symptoms associated with pregabalin:
- Headaches
- Anxiety
- Agitation
- Sweating
- Rapid heartbeat or palpitations
- Seizures
- Difficulty falling or staying asleep
- Behavioral changes
- Mood changes
- Depression
- Suicidal thoughts or behavior.
- Nausea
- Diarrhea
Withdrawal symptoms associated with gabapentin:
- Sweating
- Goosebumps (piloerection)
- Muscle pain
- Insomnia
- Anxiety
The dosage of gabapentin and pregabalin
Pregabalin is usually available in dosage forms of 50, 150, 300 mg tablets or oral solution. Usually, the dose started with 50 mg twice or three times daily and increased to reach a maximum dose of 300mg to 600mg daily according to indication. It Is recommended to take an extended dosage form after the evening meal.
Gabapentin is available in 300mg, 400mg, 600mg, 800mg tablets, and may be taken with or without food. The dosage usually ranges from 300 three times daily to 600mg three times daily according to the indication.
Drug interactions of gabapentin and pregabalin
Pregabalin interacts with drugs that cause CNS depression-like opioids and alcohol. Pioglitazone and rosiglitazone also react with pregabalin causing weight gain, fluid retention, and possibly heart failure. Therefore, combining pregabalin with these drugs may increase the occurrence of weight gain and fluid retention.
One of the most significant drug interactions with gabapentin is that antacids can reduce gabapentin concentration in blood so they must be separated by at least 2 hours. Morphine is also increasing blood concentrations of gabapentin and therefore increases the depressant effect of gabapentin.
Pregnancy and breastfeeding
Pregabalin crosses the placenta and No available data till now support pregabalin use in pregnancy, and also presented in breast milk, it is not recommended to be used with breastfeeding unless the benefits outweigh the risks.
Gabapentin is categorized as C for use in pregnancy (no evidence of risk of the fetus has not been detected), and it is recommended to use folic acid before pregnancy in women who use gabapentin.
Gabapentin is presented in breast milk by a significant amount, so it is recommended to avoid use unless the benefits outweigh the risks for the fetus.
We hope that this topic helped you to understand the difference between gabapentin and pregabalin.
The difference between gabapentin and pregabalin is clear now, correct?
Pregabalin neuropathic pain
Table of Contents
Pregabalin neuropathic pain
Neuropathic pain is a burning or severe pain that appears suddenly, it can go on its own, or can last and turn into chronic pain.
It happens as a result of a damaged or diseased nerves, this condition happens mainly due to disease, injury, infection, or loss of a limb.
The most common causes for neuropathic are:
- Alcohol addiction
- Amputation (Removing a limb as a result of severe infection, gangrene, trauma, or deformation leading to limited function and movement)
- Chemotherapy
- Diabetes
- Problems in the facial nerve
- AIDS (Acquired immunodeficiency syndrome)
- Multiple myeloma (Type of cancer)
- Multiple sclerosis (Disease in the brain and spinal cord causing deterioration of movement)
- Spinal cord injury
- Shingles (Herpes zoster virus)
- Syphilis
- Thyroid problems
Pregabalin neuropathic pain can be a very good, effective, and potent drug for managing neuropathic pain in several conditions.
Conditions managed by Pregabalin neuropathic pain:
- Neuropathic pain caused by diabetes
- Postherpetic neuralgia (Stabbing or burning pain caused by damaged or irritated nerve)
- Fibromyalgia (Muscles pain accompanied by fatigue, problems in sleep, memory, and mood)
Pregabalin neuropathic pain is the first drug approved by the FDA (Food and drug administration) in the management of fibromyalgia.
- Neuropathic pain happens after a spinal cord injury
Pregabalin is also used in other conditions as adjunctive therapy for partial-onset seizures.
Off-label uses include generalized anxiety disorder, social anxiety disorder, bipolar disorder, insomnia (sleeping problem), and chronic pain conditions.
The way Pregabalin neuropathic pain works:
It calms down the overactive or damaged nerves in the body causing pain or causing seizures.
Pregabalin neuropathic pain is available in many oral dosage forms.
Capsules, extended-release tablets, and oral solutions.
Neuropathic pain caused by diabetes:
Capsules:
- Starting with 50 mg orally every 8 hours per day
- The dose may be increased to 100 mg orally every 8 hours if needed
- The maximum dose is 300 mg per day
- Starting with 165 mg orally per day
- The dose may be increased to 330 mg orally per day if needed
- The maximum dose is 330 mg orally per day
Extended-release tablets are swallowed as a whole, without crushing, or breaking, or chewing.
Postherpetic neuralgia:
Capsules:
- Starting with 150-300 mg orally per day every 8-12 hours
- The dose may be increased to 300 mg every 8-12 hours if needed
Extended-release tablets:
- Starting with 165 mg orally per day
- The dose may be increased to 330 mg orally per day if needed
- The maximum dose is 330 mg orally per day
Fibromyalgia:
- Capsules and oral solutions only
- Starting with 75 mg orally every 12 hours
- The dose may be increased to 150 mg every 12 hours if needed
- The maximum dose is 450 mg orally per day
Neuropathic pain happens after a spinal cord injury:
- Capsules and oral solutions only
- Starting with 75 mg orally every 12 hours
- The dose may be increased to 150 mg every 12 hours if needed
Always take care of dose modifications if you are suffering from another underlying medical condition especially with Pregabalin neuropathic pain if this condition is any kind of renal impairment.
Pregabalin is not used in pediatrics except in partial-onset seizures.
Before taking Pregabalin neuropathic pain, you should inform your physician if have ever had:
- allergy to Pregabalin neuropathic pain, or any other allergies
- any kind of abuse, either to alcohol or to drugs
- swelling of the eyes, face, lips, tongue, or throat
- vision problems
- heart failure
- bleeding problems
- a low number of platelets (type of blood cells responsible for clotting)
- Lung, heart, or kidney diseases
- a surgery, or dental procedure
- mental problems, mood problems, and suicidal thoughts or acts
Drug-drug interactions:
Pregabalin neuropathic pain can cause serious side effects if combined with other drugs.
- benazepril
- captopril
- enalapril
- everolimus
- fosinopril
- imidapril
- lisinopril
- metoclopramide intranasal
- moexipril
- perindopril
- quinapril
- ramipril
- sirolimus
- temsirolimus
- trandolapril
If you are taking any of the above drugs, you should not take Pregabalin neuropathic pain, and you should use an alternative drug.
There is also a list of drugs that needs monitor closing when used in combination with Pregabalin, make sure to inform your physician about the drugs you are taking.
Side effects:
Pregabalin neuropathic pain can cause many side effects.
Common side effects:
- Dizziness
- Sleepiness
- Concentrating troubles
- Blurred vision
- Dry mouth
- Weight gain
- Swelling of limbs
These effects may go away from their own or may persist if the side effects don’t fade, inform your physician about them.
Serious side effects:
- Severe allergic reactions may be life-threatening causing swelling of some parts of the body, trouble breathing, or hives.
- Suicidal thoughts or acts
- Heart problems
- Severe dizziness
- Serious breathing problems
Always confirm with your physician the information mentioned in any article.
Lyrica UK
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Lyrica UK
Lyrica is the drug generically known as Pregabalin; mainly belongs to an anti-epileptic group of drugs.
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Lyrica is approved by the Food and Drug Administration to be used for the following medical conditions:
- Nerve pain caused by diabetes due to damage of the nerve
- Nerve pain due to shingles (Herpes-zoster) virus
- Nerve pain due to spinal cord injury
- Fibromyalgia (a condition that causes pain and weakness of the muscles)
- Partial onset seizures, Lyrica UK is used as adjunctive therapy in both adults and children older than 1-month-old
- Lyrica UK is also used in off-label uses like chronic pain conditions, generalized anxiety disorder, restless leg syndrome (To have continuous urge to move your legs especially at night, hot flashes, and social anxiety disorder
- There are also new studies that Lyrica UK can be used in association with antidepressants in depression conditions associated with signs of anxiety
Lyrica UK belongs to an anti-epileptic group of drugs, it works by decreasing the impulses in the brain responsible for seizures.
For pain management, it works by controlling the signals of pain in the brain to decrease the pain in the nerves.
What are controlled substances?
After the Shipman Inquiry’s fourth report in 2004, the government responded by introducing regulations in 2007 for some drugs which were called the controlled drugs, the supervision includes management and use.
The NHS (National Health services) should enforce the management and use of the controlled substances to prevent the harm of the patient, misuse, and criminality.
In April 2019, the government announced the reclassification of Pregabalin into class C controlled substances and put them under schedule 3 of the Misuse of drugs regulations 2001.
So, to manage the use of Lyrica UK and to avoid the misuse and wrong use of it, we should understand how to use it correctly.
Dosage and administration:
Lyrica UK should be taken exactly as the doctor prescribed.
Read the medication guide carefully before taking the drug, and if you have any questions, consult your doctor or pharmacist.
It should be taken at the same time every day to ensure constant concentration in the blood.
Extended-release tablets are taken as a whole without crushing, chewing, or breaking.
It is taken with food or without.
When using the oral solution, use a dosing syringe or any other special measuring dose device; don’t use household spoons to make sure the dose is right.
The dose may be altered according to the response to medication and the improvement or worsening of the symptoms.
When trying to stop Lyrica UK, you have to decrease the dose gradually and not stopping it at once, or else you will suffer from annoying withdrawal symptoms which are:
-
Headache
-
Mood disorders
-
Agitation
-
Depression
-
Anxiety
-
Confusion
-
Suicidal thoughts or acts
-
Nausea
-
Sweating
-
Diarrhea
-
Increased heart rate
-
Insomnia (sleeping disorder)
-
Seizures
-
Craving for the drug
If you suffered from any of these symptoms, you have to seek emergent medical care.
Lyrica UK way of working and how it acts to cause the following side effects:
- Any medication can cause a severe allergic reaction, if you suffered from hives, or swelling of the face or lips, or any other signs of allergy, stop the medication immediately and contact your doctor.
- You have to call your doctor quickly if you notice any or worsening of the following:
- Behavioral changes
- Depression
- Anxiety
- Panic attacks
- Sleeping problems
- Irritation
- Agitation
- Restlessness
- Suicidal thoughts or behaviors
- Also, Lyrica UK can cause serious side effects that need medical attention like:
- Shallow breathing
- Bluish skin, lips, fingers, or toes
- Confusion
- Extreme drowsiness
- Vision problems
- Skin sores (especially if you have diabetes)
- Unusual bleeding
- Unusual weight gain (especially if you have diabetes)
- Unusual muscle pain
- Common Lyrica UK side effects:
- Drowsiness or dizziness
- Swelling of limbs
- Inability to concentrate
- Increased appetite
- Weight gain
- Dry mouth
- Blurred vision
Lyrica UK can also interact with several drugs that can cause serious side effects.
Drug-drug interactions:
- Oral hypoglycemic drugs such as pioglitazone and rosiglitazone
- Antihypertensive drugs like ACE inhibitors as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril.
- Other seizure drugs
Don’t take any new drugs before telling your doctor about taken drugs.
Taking Lyrica UK with opioids, sleeping, cold, allergy, muscle relaxants, Anti-anxiety drugs will cause slow and shallow breathing which may be fatal.
Orlistat (a drug used to reduce weight) also interacts with Lyrica UK.
Not only drugs can cause serious effects, but alcohol also increases dizziness, drowsiness, and concentration difficulties when taken with Lyrica UK.
Lyrica UK is a very good, potent, and effective drug, but also has very serious side effects, don’t take this drug except under the supervision of a doctor.
How does pregabalin work
Table of Contents
How does pregabalin work?
Pregabaline is a famous drug to treat neuropathic pain but how does pregabalin work? And what are the other indications of pregabalin?
Pregabalin approved by the FDA for the treatment of fibromyalgia, neuropathic pain and as add-on therapy for partial-onset seizures in adults with epilepsy
There are other Off-label uses that are not approved by FDA include social anxiety disorder, generalized anxiety disorder, chronic pain conditions, insomnia, and bipolar disorder.
This article will highlight how does pregabalin work? how to take it? adverse event profile, monitoring parameters, contraindication, and toxicity.
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How does pregabalin work?
Pregabalin resembles the structure of the inhibitory neurotransmitter gamma-aminobutyric acid GABA. It has lipophilic properties to enhance the crossing of it to the blood-brain barrier. However, pregabalin indirectly binds to GABA receptors results in decreasing the influx of calcium into neurons and reduces the release of excitatory neurotransmitters.
This is why pregabalin is used as an anticonvulsant and analgesic.
How to take pregabalin?
Pregabalin is available in capsules or oral solution and administered orally. Following oral administration, pregabalin reaches max concentration in the blood within 1.5 hours and achieves a complete action within 24 to 48 hours.
The absorption of pregabalin from the stomach is independent of the dose. Pregabalin can cross the blood-brain barrier. Humans cannot significantly metabolize pregabalin. It eliminates unchanged by renal excretion. In patients with normal renal function, the elimination takes 6.3 hours.
Dosages up to 600 mg/day did not provide additional benefit and were not well-tolerated due to several side effects.
Don’t stop pregabalin suddenly but taper the dose gradually over 1 week to avoid withdrawal symptoms or exacerbation of seizures.
How much do you need from pregabalin?
Diabetic Peripheral Neuropathy:
The therapeutic dose is 300 mg/day. The start with 50 mg three times per day. Increase The dose up to 300 mg/day within one week of treatment.
Postherpetic Neuralgia:
The dose is 150 mg to 300 mg per day, and can be taken twice or three times daily. Start with a dose of 75 mg two times per day or 50 mg three times per day.
Increase the dose up to 300 mg per day within one week of treatment. If no optimal pain control within 2 to 4 weeks of treatment with 300 mg per day, increase the dose to 600 mg per day, divided into twice per day or three times per dosing.
Spinal Cord Injury:
The dose ranges from 150 mg to 600 mg per day. start with a dose of 75 mg twice per day. Increase the dose to 150 mg twice per day within one week of treatment.
The dose may be increased up to 300 mg twice per day with suboptimal pain control following 2 to 3 weeks of treatment with 150 mg twice a day. In spinal cord injury, the improvement can be seen within one week after initiating treatment. However, it is recommended to try the medication for 4 to 6 weeks.
Adjunctive Therapy with Partial Onset Seizures:
The dose is 150 mg to 600 mg per day, divided into twice per day or three times per dosing. Start the dose with no greater than 150 mg per day and increase to a maximum of 600 mg per day.
Management of Fibromyalgia:
The therapeutic dose is 300 mg to 450 mg per day. Start with a dose of 150 mg/day divided into twice per day dosing. Increase The dose to 300 mg per day within one week of treatment. If no optimal pain control on 300 mg per day may be further increased to 450 mg per day, divided into twice per day dosing.
Dosing Modifications:
Pregabalin is eliminated by the kidney. Dose adjustment is required in impaired renal function. Patients with hepatic impairment do not require dosing modifications.
Adverse events
Most of the adverse effects related to pregabalin were mild to moderate intensity.
The severity of adverse events is not dose-dependent and occurred within the first two weeks of initiating treatment.
Somnolence and dizziness are the most common adverse events that have been reported with the use of pregabalin, and they are the most frequent cause of treatment discontinuation, and of course, this is related to how does pregabalin works.
In premarketing controlled trials, The most common adverse reactions reported which occurred in greater than or equal to 5% of patients and twice the rate reported by patients receiving placebo were: dizziness, somnolence, blurred vision, dry mouth, difficulty with concentration/attention, edema, and weight gain.
Weight gain occurred in up to 14% of patients receiving 600 mg per day and was dose-dependent.
Withdrawal symptoms can occur after rapid discontinuation of pregabalin including hyperhidrosis, insomnia, nausea, nervousness, irritability, headache, anxiety, and diarrhea.
Contraindications
Pregabalin is contraindicated in case of hypersensitivity to pregabalin. There are no enough studies on pregnant women. But there are some reported cases that Pregabalin may cause fetal harm, so use caution in case if you are pregnant.
Pregabalin is not recommended in breastfeeding as it can be detected in the milk of lactating women
Monitor patients for symptoms of new or worsening depression, suicidal behavior or ideation, and other changes in behavior or mood, as pregabalin is like the other antiepileptic drugs can increase the risk of suicidal thoughts or behavior.
Pregabalin and Alcohol
Pregabalin and Alcohol
Pregabalin is an anti-epileptic and anticonvulsant drug. It works to control seizures by slowing down impulses in the brain. Also, Pregabalin affects chemicals in the brain that send pain signals across the nerves.
Pregabalin is used in the treatment of fibromyalgia, diabetic neuropathy, herpes zoster, or spinal cord injury.
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Table of Contents
Pregabalin and Alcohol:
There are two main questions to ask about while studying these two words Pregabalin and alcohol:
First: Can you drink alcohol while using Pregabalin?
Second: Does Pregabalin has a role in the treatment of alcohol dependence, alcohol withdrawal, or alcoholism?
1- Can you drink alcohol while using Pregabalin?
Drug Interaction Classification:
There are four classifications which are only a guideline for the determination of how far the risk of drug interaction with other factors:
- Major: the risk of interaction is bigger than the benefit, so, you should avoid combinations.
- Moderate: it is better to avoid combinations or it may be used only under specific circumstances.
- Minor: minimal clinically significant.
- Unknown: no available information about the interaction.
According to the previous classification, we can say that Pregabalin and Alcohol interaction is considered as a moderately clinically significant drug interaction.
So, patients are recommended to avoid alcohol generally while using Pregabalin or they may limit consumption of alcohol.
Why alcohol should be avoided or limited while using Pregabalin:
At the same time that Pregabalin acts on the central nervous system to manage pain or control seizures and convulsions by affecting nerves or affecting the release of other chemical substances in the brain, Alcohol also may potentiate some of the pharmacological effects of CNS active agents; using them simultaneously may lead to:
- excessive central nervous system depression
- excessive sleepiness or even coma
- confusion of thinking, judgment, or other psychomotor skills
- Increased drowsiness and dizziness
- Concentration issues
- It may depress the central nervous system causing breath issues leading to a potentially life-threatening condition
- Reduction of alertness
- Swelling of throat, lips, or tongue
- Itching
- Hives
How to cope with the side effects of Pregabalin?
You can avoid some factors while using Pregabalin to minimize the possible side effects that would happen:
- Headache: drink plenty of fluids, take a rest, don’t drink too much alcohol, you may ask your health provider for a suitable analgesic.
- Mood alteration: talk to your health provider as you may need to switch to a different medicine
- Feeling sick: take Pregabalin with or after a meal or snacks
- Blurred vision: during that avoid driving or using sharp or heavy tools
- Weight gain: Pregabalin increases the feeling of hunger so try to eat well healthy food, avoid too many snacks especially with meals, don’t take food with high calories. Between meals, you can eat fruits when you feel hungry. Regular sports will also help to keep your weight stable.
- For men, erection problems may occur: speak to your health care provider as he may recommend a different medicine
- Memory problems: speak to your health care provider as he may recommend a different medicine
- Swollen hands, arms, legs, or feet: avoid standing for a long time, try to sit with your feet up on a chair or bed, exercise may be useful for swollen arms.
- Feeling tired or sleepy: speak to your health care provider as he may recommend reducing the Pregabalin dose or increase it more slowly or switch to a different medicine.
2- Does Pregabalin has a role in the treatment of alcohol dependence?
Alcohol Dependence:
Alcohol dependence represents a severe pathological disorder in which patients are subjected to a high risk of morbidity or mortality. Although limited pharmacological agents are there to treat this disorder, studies are continued promising for new therapies.
- Pregabalin’s clinical use in alcoholic patients shows promise as a good treatment for the management of alcohol relapse.
- During the study made for detoxified alcohol-dependent patients receiving Pregabalin, 50%of patients remained completely alcohol-free, a significant improvement of withdrawal symptoms and alcohol craving was noticed.
- A greater beneficial effect was found in patients with comorbid conditions such as alcoholism and anxiety disorders.
- Pregabalin use appears to be safe and well-tolerated.
- Since seizures are a potential serious manifestation of alcohol withdrawal, Pregabalin’s anticonvulsant effect may be beneficial in this case.
Cautions for using Pregabalin with other medicines:
- Pregabalin can be safely used with other medicines, however, you should tell your doctor before starting Pregabalin if you take certain medicines such as strong pain killers like morphine or other medicines that make you feel dizzy or sleepy.
- There is no evidence for any problems resulting from mixing Pregabalin with supplements, vitamins, or herbal remedies.
Does Pregabalin affect fertility?
There is no evidence that Pregabalin reduces fertility in either men or women. However, if you are trying to get pregnant talk to your doctor before taking Pregabalin.
Does Pregabalin affect contraception?
Any type of contraception (including contraceptive pills and emergency contraception) is safe while using Pregabalin, it doesn’t stop contraception work.
Is Pregabalin a pain killer
Table of Contents
Is Pregabalin a pain killer?
Pregabalin is used to treat some kinds of pain that are persisting and don’t easily go away.
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It is especially used for neuropathic pain that can occur to patients suffering from diabetes (pain that happens if the nervous system is damaged or diseased).
30% of neuropathic pain happens because of diabetes, but it can also happen due to drinking alcohol and the infection with herpes zoster.
But Pregabalin can also overcome these conditions; it can treat the pain happening after the infection with herpes zoster.
It is also the first approved therapy for fibromyalgia (a disorder characterized by pain accompanied by fatigue, sleep, memory problems, and mood changes).
Pregabalin is used in managing pain coming after a spinal cord injury.
It is also used off-label in chronic pain conditions.
So, Is Pregabalin a pain killer?
Well, after all these indications, we have to say yes, Pregabalin is a very good pain killer.
How does Pregabalin manage the pain?
It controls the chemicals that cause the brain to send pain signals through the nervous system.
It reduces them resulting in reducing the pain.
Dosage and administration:
Is Pregabalin a pain killer?
Well, Pregabalin is available in many dosage forms, capsules, extended-release tablets, and oral solution.
The doses should be taken exactly as the doctor said.
If you are taking the oral solution, take it with a special measuring device (dosing syringe) or with a medical spoon.
Don’t take it with a household spoon, to make sure you are taking the correct dose.
If you are taking the extended-release tablets, take them at the same time every day.
Swallow the whole tablet without crushing, chewing, or breaking the tablet.
The dose is determined according to the severity of the medical condition, age, and weight of the patient.
Contact your doctor if you are not improving, or if the symptoms are getting worse.
If you missed a dose, take it as soon as possible, but if it is the time for the next dose, skip it and don’t double the dose.
What if you overdosed?
Go to the nearest hospital or call an ambulance immediately to prevent suffering from any serious side effects.
Is Pregabalin a pain killer?
Yes, but before using it, make sure to understand the following precautions.
Warnings:
- Pregabalin can cause an allergic reaction which may be severe, if you suffered from any hives, breathing problems, swelling in the face or lips, or even blisters on your skin, ask for emergent medical help.
- Some patients using Pregabalin may experience suicidal thoughts or behaviors; you have to tell your doctor immediately and stay alert to these changes in your mood.
- Notice any weight gain or swelling of limbs especially if you are having diabetes or heart problems.
- Pregabalin is not a drug to be stopped suddenly, the dose should be decreased gradually or else you will suffer from withdrawal symptoms.
Withdrawal symptoms:
- Seizures
- Dizziness
- Diarrhea
- Nausea
- Headache
- Vomiting
- Agitation
- Insomnia (sleeping problem)
- Tingling
- Nightmares
Is Pregabalin a pain killer?
Before taking this drug, tell your doctor about the following conditions:
- Lung diseases
- Mood disorders
- Depression or suicidal thoughts
- Heart problems
- Bleeding disorders especially congestive heart failure (a chronic condition that affects how the heart pump blood)
- Kidney diseases
- Diabetes unless it is used because of the neuropathic pain caused by diabetes
- Any sort of addiction (alcohol or drug)
- Angioedema (swelling in the lower layer of skin and tissue, it may be in the face, tongue, larynx, or other parts of the body), happens as a result of allergic reactions
Is Pregabalin a pain killer?
Yes, but take care of its side effects.
Side effects that occur in more than 10% of patients:
- Dizziness
- Somnolence
- Peripheral edema (swelling in the limbs)
- Ataxia (lack of control of the muscles)
- Fatigue
- Xerostomia (reduced saliva causing dry mouth)
- Weight gain
- Tremors
- Blurred vision
- Diplopia (Double vision)
Side effects that occur in less than 10 % of patients:
- Vertigo (Weird feeling of moving objects while they are not)
- Headache
- Constipation
- Nausea
- Limbs swelling
- Amnesia (memory problems)
- Confusion
This is not a full list of side effects; always talk to your doctor about the unusual effects that you are experiencing.
Interactions:
Is Pregabalin a pain killer?
Yes, but take care of the drug and food interactions before taking it.
Serious drug interactions use an alternative:
- benazepril
- captopril
- enalapril
- everolimus
- fosinopril
- imidapril
- lisinopril
- metoclopramide intranasal
- moexipril
- perindopril
- quinapril
- ramipril
- sirolimus
- temsirolimus
- trandolapril
There are lists of drugs that cause unwantable interactions, and need close monitoring, discuss all the drugs you are taken before taking any other drug.
Is Pregabalin a pain killer?
Yes, a very effective, potent, with very few side effects.
It also has a rapid onset and a long duration of action.
If you are suffering from any kind of pain, make sure to talk to your doctor about Pregabalin.
How long does Pregabalin take to work
Table of Contents
How long does Pregabalin take to work?
Before we talk about the time interval required for the Patient to feel better by using Pregabalin, how long does Pregabalin take to work, and to what extent Pregabalin is the drug of the choice, it’s important to know that the effect of Pregabalin differs from one patient to another, from case to another, and from dose to dose?
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Pregabalin treating different conditions:
- In fact, the way Pregabalin work for pain management, for example, is that it blocks the effect of damaged nerves responsible for sending false messages to the brain causing pain. Pregabalin changes the way these nerves work or it may calm overactive nerves which means it is a good helper with other analgesics to reduce pain by a different mechanism and shorter time to feel better.
- In patients with neuropathic pain (diabetic neuropathy or postherpetic neuralgia) time to onset of pregabalin analgesic effect under fixed-dose recorded a marked rapid onset of action.
- When you hear about the patients’ (suffering from anxiety disorders) reviews about this medicine, you find out that about 83 % of them were satisfied by its positive rapid action helping them cool down quickly. That is due to its capability to prevent the release of chemicals in the brain that makes you feel anxious.
The righter way of use, the better it works:
To get the best benefit and the fastest progress leading to a shorter time for Pregabalin to work, use Pregabalin in the right way:
- It is recommended to take Pregabalin exactly as the doctor prescribed without changing any of the instructions he said.
- Take Pregabalin at the same time every day.
- Take Pregabalin with or without food but it is preferred to take the evening dose after a good meal.
- Avoid missing pregabalin dose (if so take it once you remember that, however, avoid taking two doses at the same time).
- Avoid stopping it suddenly as it may lead to worsening the condition.
- Of course, do not stop it without talking to your medical health provider.
Back to the main question:
How long does Pregabalin take to work?
After following the previous instructions and using Pregabalin in the right way, considering the different conditions and doses for different patients:
- Some patients may experience pain decrease in the first week of treatment or even in the first few days.
- Other patients may start to feel better in the second week.
- For others, it may take a longer time according to the severity of the case, the dose of Pregabalin, and other factors. if so, you may ask your doctor for help by adjusting the dose or give you other recommendations according to the condition.
Pregabalin could be taken for a long period if it helps, you may need to gradually decrease the dose after a while to check if the pain still exists or you became much better now, but don’t stop it suddenly, you should refer to your doctor first.
The relation between Pregabalin Rapid Absorption and how long does Pregabalin take to work:
Pregabalin is rapidly absorbed after oral administration. In comparison to Gabapentin’s bioavailability (from 30 – 60%), the oral bioavailability of Pregabalin is over 90% whatever the dose received. Both Gabapentinoids (Pregabalin & Gabapentin) are absorbed across the gastrointestinal tract. The rate of Pregabalin absorption is threefold higher than that of Gabapentin, that’s why Pregabalin achieves faster peak blood concentration compared with Gabapentin
How long does Pregabalin stay in your body?
Depending on various personal factors, it stays about 33 hours higher or lower according to the patient’s age, food, and other medications.
Factors affecting how long it stays in your body:
- Age
- Dosage
- Kidney function
- Hydration
- Body mass
- PH of urine
- Duration of taking the medication
Pregabalin oral clearance is likely to decrease with increasing age, therefore, for older patients dose reduction should be considered.
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How long does Pregabalin stay in Blood, Urine, and Hair?
- In blood, it stays about 2 days after your last dose.
- In urine, it stays a litter bit longer than in blood (few days depending on the dosage).
- In hair, it stays much longer than in blood and urine, may be up to 3 months.
Too Much Pregabalin:
If you think you have taken too much of Pregabalin or you experience one or more of the following symptoms, call your health care provider at once:
- Drowsiness
- Dizziness
- Headache
- Nervousness
- Lack of control of the body movements
- Tremors
- Amnesia
Clinical Monitoring:
– To make sure that you stay safe while taking Pregabalin your doctor may ask you to do certain blood tests to check if you need to take a lower dose according to how well your kidneys are working.
– Changes in mood or behavior should be monitored as this drug may cause behavioral problems.
Pregabalin for depression
Table of Contents
Pregabalin for depression
Depression is a mood disorder that causes the person to be sad and have lost interest in life and anything.
It affects how the patient’s feelings, behaviors, and thinkings.
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It can be severe that may lead the patient to feel that life doesn’t worth to be lived.
Depression is usually associated with signs and symptoms of anxiety.
So, before talking about Pregabalin for depression, let’s understand first the relation between depression and anxiety.
The U.S (United States) National Comorbidity Study declared that 58% of patients diagnosed with major depressive disorder we also diagnosed with comorbid anxiety disorder.
As reported by Zinbarg et al., in 1994. Patients suffering from depression can show strong signs of agitation and anxiety.
Those patients suffering from anxiety and major depression are identified to have anxious depression.
These kinds of depressed patients meet the diagnosis of a comorbid anxiety disorder combined with axis II clusters (dramatic, very emotional, or surprising thinking or behavior).
So when these patients start the treatment,
the doctor should take into consideration treating the anxiety symptoms as well as treating the depression.
It is highly important to take care of the anxiety symptoms to prevent the illness to be converted to a chronic one.
Patients with depression and comorbid anxiety symptoms suffer from severe depression and suicidal thoughts with a higher risk of performing suicide.
Pregabalin could become an excellent added drug to the antidepressant in patients suffering from depression associated with anxiety and agitation, which may also replace benzodiazepines during the first period of treatment as it outweighs them in the onset of action, which is a very big benefit for the patients.
Few studies had already shown the benefits of adding Pregabalin to the therapy regimen of patients suffering from depression not completely responding to antidepressant medications, or in elder patients suffering from a comorbid generalized anxiety disorder.
Pregabalin has already shown a very good anti-anxiety effect in patients with generalized anxiety disorder.
It is also very effective in the prevention of relapse of patients suffering from a generalized anxiety disorder.
Pregabalin for depression is a well-tolerated drug with fewer side effects and less risk for dependence.
Although new data have shown susceptibility of abuse when using Pregabalin for depression, it possesses comparable effectiveness with benzodiazepines, with no major interactions.
In treating depression and anxiety, the often-used were a combination of antidepressant drugs, which showed 2-4 weeks onset of action, which may cause complete disturbance for the patient and may cause him to stop the therapy.
Pregabalin for depression has proved to work from the first week by reducing the symptoms of anxiety and depression.
Anxiety symptoms were measured by the HAMA scale (Hamilton Anxiety Rating Scale), and the depressive symptoms were measured by the HAMD (Hamilton Depression Rating Scale), and those scales were found to decrease starting the treatment and throughout the therapy period.
So, what is Pregabalin?
Pregabalin for depression is an anti-epileptic drug.
It slows down the impulses send by the brain to cause seizures, and also affects the chemicals that send signs of pain across the nervous system.
Uses and indications:
Pregabalin is not just used for depression, it has many other uses.
- Peripheral neuropathic pain associated with diabetes
- Neuralgia happening after the infection with the herpes zoster virus
- The pain caused by fibromyalgia, the first drug approved for this case
- Partial-onset seizures
- Neuropathic pain happening after spinal cord injury
- used off-label in generalized anxiety disorder, bipolar disorder, insomnia (sleeping disorder), social disorders, and conditions of chronic pain
N.B. Neuropathic pain is pain happening from what is supposed to not be painful due to damage or disease affecting the nervous system.
Dosing and administration:
Pregabalin for depression is available in many dosage forms but all of them are orally taken forms, no injectable or rectal ones.
The dose should be taken exactly as prescribed by the doctor.
The dose depends on the age and weight of the patient and also on the medical condition.
Interactions:
As we clarified before, there are no contraindicated drugs to be concomitantly used with Pregabalin for depression, but there are drugs that may cause serious interactions that the patient should use an alternative drug in this case.
- benazepril
- captopril
- enalapril
- everolimus
- fosinopril
- imidapril
- lisinopril
- metoclopramide intranasal
- moexipril
- perindopril
- quinapril
- ramipril
- sirolimus
- temsirolimus
- trandolapril
Pregabalin should not be also used while consuming alcohol, as alcohol can increase the side effects of the nervous system, dizziness, drowsiness, and concentration problems.
Pregnancy and lactation:
Pregabalin for depression should only be given to pregnant women when there are no other alternatives, and when the benefits outweigh the risks.
Breastfeeding while on drug therapy with Pregabalin, tumorigenicity could happen (susceptibility for growing tumors either benign or malignant).
So breastfeeding is not recommended while using Pregabalin for depression.
This is not a full list of information about Pregabalin for depression; always talk to your doctor about the full information about any drug before taking it.
