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Why it's used

Pregabalin is used for the management of nerve pain associated with nerve damage due to uncontrolled high blood sugar (neuropathic pain associated with diabetic peripheral neuropathy) and nerve pain associated with nerve inflammation caused by infection (postherpetic neuralgia). This medicine works by decreasing the number of pain-inducing signals that are sent out by damaged nerves in the body. Pregabalin is also used to relieve neuropathic pain after spinal cord injury, and to treat widespread muscle pain and tenderness and certain types of seizures in adults and children.
Anti-epileptic Agent
Pregabalin is a prescription medicine that belongs to a class of medicines called Anti-epileptic Agent. Antiepileptic drugs are a class of medicines which are used to treat epilepsy by controlling seizures.

How to use

Read the medicine guide provided by your pharmacist, your doctor, or the medicine company. If you have any questions related to Pregabalin, ask your doctor or pharmacist. Use Pregabalin as per the instructions provided by your doctor.
Pregabalin is consumed with or without food. Pregabalin should be swallowed whole and should not be split, crushed and chewed. Pregabalin is consumed usually taken just after an evening meal. Taking Pregabalin once daily after an evening meal may show similar levels of Pregabalin in blood as compared to taking Pregabalin twice daily without food.
The typical dose of Pregabalin for adults is 330-660 mg/day. The maximum dose for adult patients of Pregabalin is 330-660 mg per day. Pregabalin is commonly used at the same time every day. Although this medicine is useful to people, it may sometimes be habit-forming or cause addiction. You may be at higher risk if you have a substance use disorder, such as an addiction to drugs, or have an existing addiction, such as to alcohol. To reduce your risk of addiction, take this medicine as prescribed.
This medicine should be used on an as-needed basis. Pregabalin should be used as directed by the doctor even if you feel well, or even if you think that there is no need for you to use your medicine.
Discuss with your doctor if you develop new or worsening symptoms. Discuss with your doctor if depression, unusual changes in mood or behavior, thoughts about suicide or dying, insomnia, attempts to commit suicide, irritability, new or worse depression, acting aggressive, being angry, or violent, new or worse anxiety, acting on dangerous impulses, feeling agitated or restless, an extreme increase in activity and talking (mania), panic attack, and unusual changes in behavior or mood. If you have any kidney disease, kidney creatinine clearance is monitored in patients with abnormal functioning of the kidney, and according to the creatinine clearance rate, the dose of Pregabalin is adjusted. Consult with your doctor before stopping the use of Pregabalin.
Your doctor may prescribe a lower starting dose of this medicine to understand the impact on the body. Please follow your doctor's recommendations. A lower dose of this medicine may be recommended to reduce the risk of side-effects. Older patients may see an increase in the incidence of side-effects. As a result, a lower dose may be recommended for older patients.
When stopping this medicine, some patients may experience withdrawal symptoms like insomnia, nausea, headache, anxiety, diarrhea, and increased seizure. You may need to taper (gradually decrease) the dose of this medicine when stopping.
The safety and effectiveness of using Pregabalin in children has not been established.
To decrease the possibility of side-effects, you might be recommended to use the extended-release form of this medicine by your doctor. The extended-release medicine helps in maintaining a steady level of the medicine in your body for a longer period of time. Do not crush or chew the medicine, unless indicated on the package or by your doctor.
Avoid consuming alcohol together with Pregabalin.
Medicines may be recommended for uses other than those listed in the medicine guide. You should not use Pregabalin for conditions or symptoms for which it was not prescribed. Do not give Pregabalin to other people, even if they have the same conditions or symptoms that you have. The use of this medicine without the advice of a doctor may cause harm.
Follow storage instructions on the product package if available. Store Pregabalin at 20°C to 25°C (68°F to 77°F), away from moisture, and away from heat. Store this medicine away from children and pets.

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How to take Pregabalin

Your dose may depend on several personal factors. You should consult with your doctor to find out the dose that is best for you. The dose of Pregabalin depends on the following factors:
  • patient's age
  • patient's health
  • the health of the patient's liver
  • response to treatment

Pregabalin Dosage

Dosage for nerve pain associated with nerve damage due to uncontrolled high blood sugar (neuropathic pain associated with diabetic peripheral neuropathy)

Adult
  • Initial: 165 mg/day as a single dose
  • Maximum: 330 mg/day as a single dose within 1 week

Dosage for nerve pain associated with nerve inflammation caused by infection (postherpetic neuralgia)

Adult
  • Initial: 165 mg/day as a single dose
  • Maximum: 330-660 mg/day within 1 week

Forms

capsule
Strength: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg
Extended release tablets
Strength: 82.5 mg, 165 mg, and 330 mg

Missed Dose

During consumption of capsules or the oral solution, if you forget to take a dose, then take the missed dose as soon as you remember it. However, if it is the time for the next dose, then the missed dose should be skipped, and the regular dosing schedule should be continued. Do not double your dose to make up for a missed dose. If the patients forgot to take an extended-release form of Pregabalin after the evening meal, then they should take their usual dose before bedtime with snacks. If in case patients miss a dose of Pregabalin before bedtime than they should take their usual dose with the morning meal.

Overdose

What to do if you overdose on Pregabalin?
The unabsorbed portion of the drug in the stomach is eliminated by inducing vomiting and stomach emptying (gastric lavage). General supportive care includes the monitoring of vital signs such as body temperature, blood pressure, heartbeat, breathing rate should be considered.
If you think you have overdosed on Pregabalin, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Pregabalin

Before you use Pregabalin, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information.
Before you use Pregabalin, tell your doctor of your medical history including alcohol consumption, overuse of prescribed medicines, swelling of the eyes, face, lips, tongue, or throat, vision problems, heart failure, bleeding problems, low number of platelets, kidney disease, patients who undergone surgical dental procedures, or patients with mental disorders. Taking Pregabalin in the patient with the history of drug abuse may develop tolerance, progressive increase strength of drug taking (drug escalation) and drug-seeking behavior. Rapid discontinuation of Pregabalin may increase the seizures frequency in the patient taking Pregabalin with a seizure disorder. Before having any surgery, discuss with your doctor and dentist about medicines you use including prescription medicines, non-prescription medicines, and herbal supplements.
The use of Pregabalin may change PR interval. Patients taking more than or equal to 300 mg/day of Pregabalin may develop an increased PR interval.
The use of this medicine may change platelet count. Decreased levels of platelets were observed in patients taking Pregabalin treatment.
The use of Pregabalin may change creatine kinase in the blood. The use of Pregabalin may cause muscle injury (rhabdomyolysis) and increased levels of creatine kinase in the body.
Consult with your doctor on the use of Pregabalin during pregnancy or if you are planning to become pregnant. Consult with your doctor on the use of Pregabalin during breastfeeding. This medicine may pass into breast milk, so breastfeeding is not recommended during Pregabalin treatment. Consult with your doctor on the use of Pregabalin, if you are trying to conceive.
Avoid drinking alcohol with Pregabalin. Consumption of alcohol may cause movement and coordination problem in legs, arms and other body parts, and sleepiness.
Pregabalin can make you feel sleepy. Be careful, especially while driving, while using heavy machinery, or when doing any activity that needs you to be completely alert. The consumption of alcohol with Pregabalin can worsen the sleepiness.
Older patients may have a higher incidence of side-effects when using Pregabalin.

What precautions should be taken during Pregnancy and Nursing, and administering Pregabalin to Children or the Older Adults?

Pregnant Women

No Known Risk
Warning: It is unknown whether Pregabalin may affect the unborn baby so consult with your doctor before taking Pregabalin in pregnancy.

Breastfeeding

No Known Risk
Warning: Pregabalin may pass into breast milk so consult with your doctor while breastfeeding an infant.

Younger Adults Population

Contraindicated or Not Recommended
Warning: Due to lack of safety and effectiveness data, Pregabalin is not recommended for children.

Older Adults Population

Management or monitoring precaution
Warning: Proper adjustment of dose is required in elderly patients with abnormal functioning of the kidneys.

Pregabalin Side-effects

The following side-effects may commonly occur when using Pregabalin. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
Rarely, the use of Pregabalin may cause the following side-effects:
  • abnormal coordination
  • abnormal dreams
  • abnormal ejaculation
  • abnormality of voluntary movement (dyskinesia)
  • abnormally low levels of thrombocytes
  • addiction
  • agitation
  • altered state of consciousness
  • artial or complete loss of muscle movement (hypokinesia)
  • blood clot formation in the vein (deep thrombophlebitis)
  • blood in the urine (hematuria)
  • bone marrow cancer (myelofibrosis)
  • chest pain
  • cloudy urine (urate crystalluria)
  • cognitive disorder
  • decrease in the number of leukocytes (leukopenia)
  • decrease taste sensitivity
  • decreased glucose tolerance
  • decreased prothrombin
  • deficit in memory (amnesia)
  • depressed level of consciousness
  • difficulty swallowing (dysphagia)
  • dysautonomia
  • excessive physical sensitivity (hyperesthesia)
  • facial pain
  • fainting
  • hallucinations
  • hyperactivity and inability to concentrate ( hyperkinesia)
  • inability to empty the bladder
  • inability to formulate language (aphasia)
  • increase in the number of eosinophils in the blood (eosinophilia)
  • increase in the number of platelets (thrombocythemia)
  • increase in the number of red blood cells (polycythemia)
  • increase in the number of white blood cells (leukocytosis)
  • increased neutrophil count
  • increased sensitivity to pain (hyperalgesia)
  • increased sex drive (increased libido)
  • infection of the lungs (pneumonia)
  • inflammation of the kidney (nephritis)
  • inflammation of the pancreas (pancreatitis)
  • involuntary muscle contractions (dystonia)
  • involuntary muscle jerk (myoclonus)
  • involuntary muscular movement (myokymia)
  • irritability
  • joint stiffness
  • kidney stone (kidney calculus)
  • lack of interest (apathy)
  • lack of red blood cell (anemia/hypochromic anemia)
  • low blood pressure
  • low blood pressure while standing up from a lying or sitting position
  • low muscle tone (hypotonia)
  • lung swelling
  • middle ear infection (otitis media)
  • motor abnormalities (cerebellar syndrome)
  • mucosal dryness
  • muscular rigidity (cogwheel rigidity)
  • nerve pain (sciatica)
  • pain in the coccyx or tailbone area (coccydynia)
  • painful or difficult urination
  • palpitations
  • presence of albumin in the urine (albuminuria)
  • presence of protein in the urine
  • psychomotor hyperactivity
  • red or purple discolored spots on the skin
  • reduced urination
  • retinal vascular disorder
  • severe pain due to damaged nerve (neuralgia)
  • sleep phase rhythm disturbance
  • slowness of movement (bradykinesia)
  • speech disorders
  • stomach pain
  • swelling around the eyes
  • swelling of the breast tissue (gynecomastia)
  • swelling of the face
  • swelling of the stomach
  • swelling of the tongue
  • swollen or enlarged lymph nodes
  • unfriendliness (hostility)
  • vaginal discharge (leukorrhea)
The following severe side-effects may also occur when using Pregabalin:
  • nervous system disorders
    Symptoms: altered mental state (encephalopathy), movement disorder (extrapyramidal syndrome), disturbance in mental abilities (delirium), serious mental illness (delusions) coma
  • stomach and intestinal disorders
    Symptoms: lipase increased, increased creatine kinase levels partly or entirely blockage of the small or large intestine (intestinal obstruction)
  • suicidal behavior and ideation
    Symptoms: thoughts about suicide or dying, insomnia, attempts to commit suicide, irritability, new or worse depression, acting aggressive, being angry, or violent, new or worse anxiety, acting on dangerous impulses, feeling agitated or restless, an extreme increase in activity and talking (mania), panic attack unusual changes in behavior or mood
    Contact the doctor immediately if such symptoms occur.
  • heart disorders
    Symptoms: heart failure rapid heart beat
  • skin disorders (life-threatening respiratory function abnormality)
    Symptoms: life-threatening skin reaction (Stevens-Johnson Syndrome), presence of red blood cells in the urine, swelling of the face, swelling of the mouth swelling of the neck
    Use of Pregabalin should be discontinued and contact the doctor immediately if such symptoms occur.
  • allergic reactions
    Symptoms: skin redness, blisters, hives, rash, trouble breathing (dyspnea) wheezing
    If any of these symptoms occur, discontinue the use of Pregabalin and contact the doctor immediately.
Your doctor has prescribed Pregabalin because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Pregabalin.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Pregabalin by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Severe Side-effects

Following are the severe side-effects of this medicine:

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
If any of these symptoms occur, discontinue the use of Pregabalin and contact the doctor immediately.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Swelling of the lower layer of skin

Patients with the previous episode of swelling of the lower layer of skin, using Pregabalin, or drugs associated with swelling are at an increased risk. The use of Pregabalin may cause swelling of the face, neck (larynx and throat), and mouth (tongue, gums, and lips) and abnormality in respiratory function (respiratory compromise) in these patients. Take necessary precautions while using Pregabalin in patients with previous history of swelling of the lower layer of the skin.

Allergic reactions

Patients using Pregabalin are at an increased risk of emergence of allergic symptoms. These patients may experience allergic reactions shortly after starting Pregabalin therapy, which includes hives, wheezing, rash, difficulty in breathing (dyspnea), skin redness, and blisters. Pregabalin should be discontinued immediately on the occurrence of the allergic reaction.

Suicidal behavior and ideation

Patients with epilepsy, other psychotic disorders or taking Pregabalin are at increased risk. The use of Pregabalin may increase the risk of suicidal behavior or thoughts, worsening of the depression, and unusual changes in behavior or mood changes in these patients. Carefully monitor the patients for the emergence or worsening of depression, suicidal thoughts and mood or behavioral changes.

Dizziness and drowsiness

Patients using Pregabalin alone or with other central nervous system drugs are at increased risk. The use of Pregabalin may cause dizziness and drowsiness in these patients. The effects may worsen on combined usage of Pregabalin with other central nervous system drugs. Patients should be informed about their weakened ability to perform tasks such as operating machinery or driving due to Pregabalin related drowsiness and dizziness.

Weight gain

Patients using Pregabalin are at an increased risk. The use of Pregabalin may cause weight gain.

Abrupt or rapid discontinuation of treatment with Pregabalin

Patients with seizure disorders or who suddenly discontinue using this medicine are at increased risk. These patients may develop symptoms including diarrhea, headache, nausea, anxiety, seizures, and insomnia. Pregabalin should not be discontinued suddenly rather it should be tapered slowly over a minimum of 1 week.

Eye-related effects (ophthalmological effects)

Patients using Pregabalin are at increased risk. The use of Pregabalin may cause vision-related events such as blurred vision in these patients. If this happens, contact your doctor right away. Frequent assessment should be considered in patients with persisting visual disturbance and in patients who are already examined for eye conditions.

Increased level of creatine kinase in the blood (creatine kinase elevations)

Patients using Pregabalin are at increased risk. The use of Pregabalin may cause muscle injury (rhabdomyolysis) and increased levels of creatine kinase in the body. Tell your doctor immediately on the occurrence of tenderness, weakness, muscle pain, fever, and feeling of discomfort. Pregabalin should be discontinued if (abnormality in muscle fiber) myopathy or increased level of creatine kinase in the blood occurs.

Low levels of thrombocytes and heart block (PR Interval prolongation)

Patients using Pregabalin are at increased risk. The use of Pregabalin causes low levels of thrombocytes and heart blockage in such patients.

Swelling of the lower legs or hands

Patients using Pregabalin alone or with thiazolidinedione antidiabetic agent are at an increased risk. These patients may experience higher frequencies of weight gain and swelling of the lower legs or hands, which may lead to heart failure. Such patients should be monitored for the occurrence of swelling of the skin when using Pregabalin with thiazolidinedione antidiabetic agent. There are no sufficient studies of heart failure patients, these patients should be monitored for the worsening of heart failure.

Interactions with Pregabalin

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
Your doctor's guidelines may need to be followed while taking this medicine along with gabapentin which is used to treat seizures and convulsions. The use of Pregabalin with gabapentin may small decrease the absorption of Pregabalin in the body.
Pregabalin interacts with narcotic pain medicines such as oxycodon and antianxiety drugs such as lorazepam which are used to treat severe pain and anxiety disorder respectively. Using Pregabalin with these medicines may increase the chance of movement and coordination problem in legs, arms and other body parts. It may also lead to sleepiness. Discuss with your doctor before start using these medicines with Pregabalin.
There may be an interaction of Pregabalin with rosiglitazone, metformin, pioglitazone which are used to treat diabetes. When Pregabalin is used with these medicines, may lead to increased chances of weight gain or swelling in hands or feet. Talk to your doctor before start using these medicines with Pregabalin.
Pregabalin may interact with angiotensin-converting enzyme (ACE) inhibitors such as benazepril, captopril enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril which are used to treat high blood pressure. Using Pregabalin with angiotensin-converting enzyme (ACE) inhibitors may cause swelling and hives. Talk to your doctor before start using these medicines with Pregabalin.
Special instructions need to be followed while taking this medicine along with erythromycin which is used to treat bacterial infection. The combined use of Pregabalin with erythromycin may decrease the levels of Pregabalin in blood.
There may be an interaction of Pregabalin with sedatives sleeping pills and tranquilizer, which are used to treat anxiety, fear, tension, sleep disturbances, and agitation. Consult with your doctor before taking these medicines with Pregabalin. The doctor may change the dosage of medicines and monitor the patient for side-effects.
Pregabalin may interact with antidepressants, antihistamines which are used to treat depression and allergic reactions respectively. Talk to your doctor before taking these medicines with Pregabalin. The doctor may change the dosage of medicines and monitor the patient for side-effects.
This page does not contain all the possible interactions of Pregabalin. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Interactions of Pregabalin by Severity

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Pregabalin be not used?

Allergic to Pregabalin

This medicine should not be used in patients who are allergic to it or any of its components. These patients may have the following symptoms if they use this medicine:

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Pregabalin is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Pregabalin .
Neuropathic Pain
What Is Diabetic Neuropathy?
Postherpetic Neuralgia
Seizures

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