Drug Index

Pregabalin

 
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Mechanism :

Precise mechanism of action unknown but is a GABA analogue that binds to a subunit of voltage-gated calcium channels in CNS; does not affect sodium channels, opiate receptors, or cyclo-oxygenase enzyme activity; interactions with descending noradrenergic and serotonergic pathways originating from the brain stem appear to reduce neuropathic pain transmission from spinal cord.


Indication :

• Neuropathic pain (diabetic, spinal cord injury associated)

• Post-herpetic neuralgia

• Adjunctive therapy in partial seizures

• Fibromyalgia


Contraindications :

Avoid abrupt withdrawal.


Dosing :

Partial Onset Seizures:

1 month to 16 years:

< 29 kg: 3.5 mg/kg/day PO given in 2 or 3 divided doses; may increase the dosage weekly up to 14 mg/kg/day.

>30 kg: 2.5 mg/kg/day PO given in 2 or 3 divided doses; may increase the dosage weekly up to 10 mg/kg/day. Max: 600 mg/day.


Adverse Effect :

Hypersensitivity reaction, anaphylactoid reaction, angioedema, exfoliative dermatitis, Stevens-Johnson syndrome, thrombocytopenia, rhabdomyolysis, withdrawal seizures if abruptly discontinued.


Interaction :

Interaction Characteristics:
CNS depression.
Avoid/Use Alternative:
Doxylamine, Ginkgo.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
30-60Initial dose 75 mg daily and titrate according to tolerability and response
15-30Initial dose 25–50 mg daily and titrate according to tolerability and response
<15Initial dose 25 mg daily and titrate according to tolerability and response

Dose in Patients undergoing Renal Replacement Therapies
CAPDDialysed. Dose as in GFR<15 mL/ min
HDDialysed. Dose as in GFR<15 mL/ min
HDF/High fluxDialysed. Dose as in GFR<15 mL/ min
CAV/VVHDDialysed. Dose as in GFR=15– 30 mL/min

Hepatic Dose :

No dose adjustment recommended.
04/10/2020 10:15:50 Pregabalin
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