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Evidence-based medicine, rational drug use
Pregabalin is a gamma-aminobutyric acid (GABA) structural analog that blocks voltage-dependent calcium channels and reduces neurotransmitter release. It is commonly used clinically for the treatment of post-herpetic neuralgia, neuropathic pain associated with diabetic peripheral neuropathy, fibromyalgia, and adjuvant therapy for partial-onset epilepsy, and it is also effective for other pathological pains.
There is growing interest in the therapeutic role of pregabalin in chronic pain. So what should be paid attention to when using this drug? Jie Xiaoyao will tell you.
How do I stop the medication properly?
As with all antiepileptic drugs (AEDs), gradually discontinue pregabalin to minimize increased seizure frequency in people with epilepsy. After abrupt or immediate discontinuation of pregabalin, some patients experienced symptoms including insomnia, nausea, headache, anxiety, hyperhidrosis, and diarrhea. If pregabalin is discontinued, the dose should be tapered over at least 1 week rather than abruptly discontinued.
Beware of suicide risk!
Patients taking AEDs, including pregabalin, for any indication are at increased risk of suicide.
Patients receiving any AED treatment should be carefully monitored for the onset or worsening of depression, suicidal thoughts or behavior, and other emotional or behavioral abnormalities.
Epilepsy and many other conditions that use AEDs are associated with an increased risk of suicidal thoughts and behaviors due to the disease itself and morbidity and mortality. If suicidal thoughts and behaviors occur during treatment, physicians need to consider whether the presence of these symptoms in any patient is related to the disorder being treated.
How is an overdose treated?
In post-marketing experience, the most commonly reported adverse events of pregabalin overdose included decreased consciousness, depression/anxiety, confusion, agitation and agitation, seizures and cardiac conduction were also reported block. Death has been reported in overdose of pregabalin alone or in combination with other central nervous system depressants [1-3].
There is no specific antidote for a pregabalin overdose. Pregabalin can be removed by hemodialysis. Standard hemodialysis procedures can significantly clear pregabalin (approximately 50% within 4 hours) [1-3].
References:
[1]Product Information:PREGABALIN capsule,Alembic Pharmaceuticals Inc.,Updated September 30,2021.
[2]Product Information:PREGABALIN capsule,PREGABALIN solution,Greenstone LLC,Updated July 8,2020.
[3]Product Information:PREGABALIN tablet,film coated,extended release,MSN LABORATORIES PRIVATE LIMITED,Updated May 25,2021.
Source: Clinical Pharmacy Channel
Author: Wang Xue, Jie Xiaoyao
Review: Wang Shuping Chief Pharmacist
Editor in charge: Wang Hang
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