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Pregabalin 75mg for Intractable Pain - Last-Resort Therapy?

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Pregabalin, also known as Lyrica, is used to treat neuropathic pain conditions such as fibromyalgia and some types of seizures. It is a controlled substance, and doctors closely monitor patients’ use of the drug.

It can cause breathing problems if taken with other drugs that affect the central nervous system. Get emergency medical help if you have slow breathing with long pauses, blue lips, or trouble waking up.

What is Pregabalin?

Pregabalin 75mg is a medication in the gabapentinoid class of drugs, also known as anticonvulsants. It works by controlling the chemicals in your brain that send pain signals to your nerves. It has been approved by the United States Food and Drug Administration (FDA) to treat neuropathic pain associated with diabetes or herpes zoster (postherpetic neuralgia), as well as fibromyalgia. It is also used to reduce the frequency of seizures in people with epilepsy.

It comes as a capsule and liquid solution. The brand name version is Lyrica. Pregabalin is a controlled substance and should be kept out of the reach of children. This medicine may interact with other medicines. Tell your doctor before taking this drug with opioids, cold or allergy medications, sedatives, muscle relaxers, or other medicines that can slow breathing. This medicine can cause a rare but serious reaction called "hypersensitivity reaction." Stop taking this drug and get emergency medical help if you have trouble breathing, hives, or blisters on your skin.

The recommended starting dose of this medication for adults is 75 milligrams per day. Your doctor will adjust your dose based on your condition. This medication can be taken with or without food. If you have kidney problems, your doctor may start you on a lower dosage or a different dosing schedule.

How Does Pregabalin Work?

Pregabalin (Lyrica) is used to relieve neuropathic pain (pain from damaged nerves) in adults. It can help to improve the symptoms of diabetic neuropathy (the burning, stabbing pain or tingling that may occur in your arms, hands, fingers, legs, feet, and toes) and postherpetic neuralgia (the burning, stabbing pain or aches that can last for months or years after you have had shingles). It is also used to treat fibromyalgia (a long-lasting condition that causes muscle stiffness and tiredness).

It works by blocking pain messages from reaching your brain. It can also reduce anxiety by stopping your brain from releasing the chemicals that make you feel nervous. It is thought to be safer than other drugs for neuropathic pain and has few side effects.

The medication can be taken by mouth or through the skin. It is usually started at a low dose and gradually increased over a few days or weeks to the highest dose that is tolerated. It is important to take the exact dose as prescribed by your doctor. Your doctor may do blood tests to check your kidney function and to see how well the drug is working. Your doctor should watch you closely for depression and suicidal thoughts or behavior. Tell your doctor right away if you have any of these signs.

Dosage

For this drug to work, it must be taken regularly and exactly as prescribed. It should never be used in place of other treatment options, and it is important for physicians, pharmacists, nurse practitioners, and physician assistants to monitor patients to ensure proper dosing. Because pregabalin is primarily eliminated by renal excretion, dosage adjustment in patients with reduced creatinine clearance and those who undergo hemodialysis is recommended.

Because this medication can cause severe breathing problems, it is important to tell a doctor if you have trouble breathing, especially when you are taking it with other medicines that can also affect breathing such as oxycodone and codeine or alcohol. You should also tell your doctor right away if you have any new or unexplained sores on your skin or if you have any other side effects that worry you.

Appropriate studies have not been performed to demonstrate geriatric-specific issues that would limit the usefulness of this medication in elderly patients. However, due to a higher risk of drowsiness and dizziness, older adults may require a lower dose or less frequent dosing. Your doctor will adjust your dosage based on your age, kidney function, and other medical conditions.

Side Effects

If you have a history of depression or suicidal thoughts, talk to your doctor before taking pregabalin. This drug can increase your risk of these side effects.

This drug can cause dizziness and drowsiness. Avoid driving or operating machinery until you know how it affects you. This drug can also interfere with your ability to think clearly. Do not drink alcohol or take other drugs that may impair your mental alertness while you are taking this medication.

Efficacy for this medication has been demonstrated in patients with both peripheral diabetic neuropathy (PN) and postherpetic neuralgia (PHN; the burning, stabbing pain or aching that lasts for months or years after shingles). In a multicenter placebo-controlled study, patients who took 150 or 600 mg of pregabalin per day experienced significant reductions in neuropathic pain symptoms compared to those who took a placebo.

This medication is generally well-tolerated, but some people develop severe or even life-threatening side effects. The risk of these side effects is higher if you are elderly, have liver disease or kidney problems, take opioid medications, or have certain medical conditions. In rare cases, this drug can lead to a serious lung or breathing problem called respiratory depression. If this occurs, call your doctor immediately. Also, tell your doctor if you are pregnant or breastfeeding. This drug passes into breast milk and can harm a nursing baby.

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