pregabalin: Price, Dosage & Where to Buy

Pregabalin is a gabapentinoid and alpha2-delta calcium-channel ligand used mainly to manage neuropathic pain. It is also prescribed as add-on treatment for partial-onset seizures, fibromyalgia, and neuropathic pain linked with spinal cord injury. Pregabalin requires a prescription in the United Kingdom, and a generic version has been available since 2019-07-19.

Pregabalin is used for neuropathic pain associated with diabetic peripheral neuropathy, where nerve damage related to diabetes causes pain or abnormal sensations. It is also used for postherpetic neuralgia, a painful nerve condition that can follow shingles. Pregabalin may be prescribed as adjunctive treatment for partial-onset seizures in patients 1 month of age and older.

Other listed uses are fibromyalgia and neuropathic pain associated with spinal cord injury. The medicine is therefore used for both nerve-related pain and certain seizure disorders. Treatment choice and monitoring depend on the condition, age, kidney function, other medicines, and response to treatment.

The label lists capsules containing 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, and 300 mg, an oral solution containing 20 mg/mL, and extended-release film-coated tablets containing 82.5 mg, 165 mg, and 330 mg. The usual starting dose is 150 mg/day for adult indications. The label lists administration in two or three divided doses for many adult uses, with some paediatric seizure regimens using one, two, or three divided doses according to age and body weight.

The label lists dose adjustment for adult patients with reduced renal function. The label lists oral administration with or without food. The label lists gradual tapering over a minimum of 1 week when treatment is discontinued.

The label lists maximum daily doses that vary by indication, including 300 mg/day, 450 mg/day, and 600 mg/day. Paediatric seizure dosing is weight-based and includes mg/kg/day regimens.

Pregabalin belongs to the gabapentinoid class and binds to the alpha2-delta subunit of voltage-gated calcium channels in the nervous system. This reduces the release of several excitatory signalling chemicals from nerve cells. By calming excessive nerve signalling, pregabalin can reduce abnormal pain signals and help limit the electrical activity involved in some seizures.

Its action is different from that of traditional painkillers and does not work by directly reducing inflammation. The same general calming effect on nerve activity can also contribute to dizziness, sleepiness, and problems with concentration. Pregabalin is eliminated mainly through the kidneys, so kidney function can affect how the medicine is handled.

Observational studies suggest a possible small increase in overall major birth defects with pregabalin exposure during pregnancy, but no consistent or specific pattern of major birth defects has been identified. Available data on miscarriage and other maternal, fetal, and long-term developmental effects are insufficient to identify risk. Extended use with opioids close to delivery may increase the risk of neonatal withdrawal.

Breastfeeding is not recommended. Pregnancy or breastfeeding should be discussed with a doctor or pharmacist before treatment changes.

A missed dose should not usually be replaced by taking extra medicine. General pharmacy advice is to take the missed dose when remembered unless the next dose is close, then continue the regular schedule and seek advice from a pharmacist or prescriber.

Pregabalin should not be stopped abruptly, because rapid discontinuation can increase seizure risk and may cause withdrawal symptoms. The label lists gradual tapering over a minimum of 1 week when treatment is discontinued.

Store pregabalin at 25°C. Excursions are permitted from 15°C to 30°C. Keep the medicine in its packaging, protected from moisture and excessive heat, and as directed on the label to maintain quality.