PREGABALIN
Dr. C P Ravi Kumar
Dr. C. P. Ravi Kumar Lead & Senior Consultant – Paediatric Neurology, The Krishna Institute of Medical Sciences (KIMS), Mahadevapura, Bangalore
What is Pregabalin?
Pregabalin is a prescription medication used to treat several conditions, primarily involving nerve pain and neurological disorders.
What is Pregabalin used for?
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Partial seizures
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Post herpetic Neuralgia
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Diabetic Neuropathy
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Fibromyalgia
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Generalized anxiety disorder
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Restless leg syndrome
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Social anxiety disorder
What is Pregabalin available as?
- Capsule
- Oral solution/ Syrup
- Extended-release tablet
How does Pregabalin act (mechanism of action)?
Pregabalin is a gamma-aminobutyric acid (GABA) analogue, but it doesn’t act on GABA receptors. Instead, it binds to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, which helps reduce the release of neurotransmitters like glutamate, norepinephrine, and substance P, thereby reducing the frequency of seizures.
Can Pregabalin and Gabapentin be taken together?
Pregabalin and Gabapentin are similar medications, both used to treat nerve pain and seizures. They work in a similar way, so taking them together is usually not recommended unless prescribed by a doctor (but cross check with your doctor)
How much time does Pregabalin take to act?
- Peak plasma concentrations attained within 1.5 hours following oral administration of conventional preparations and within 12 hours following extended-release preparations.
- Within 24 to 48 hours after repeated dose of conventional Pregabalin and 48 to 72 hours after repeated administration of extended-release Pregabalin, steady-state concentrations are reached.
However, considering dosage, frequency, and individual reaction, it can take a few days or weeks to see improvements in seizure control.
Why is Pregabalin important for you / your child’s treatment?
Pregabalin is important for treatment because it helps reduce nerve-related pain and control seizures. This leads to better overall quality of life and symptom management.
What is the ideal time to take Pregabalin?
The suggested intake for Pregabalin is twice daily, ideally 10–12 hours apart (e.g., 7-8 am and 7-8 pm). Follow your doctor’s advice if a thrice-a-day regimen is recommended, and aim for consistent timing daily to establish a routine and reduce missed doses.
Extended-release tablets: Initially, once daily after the evening meal.
What if I miss the dose?
If you missed to take the tablet, you must take it as soon as you remember. However, if it is nearly time for your next dose, simply skip the missed one and continue with your regular schedule.
NEVER GIVE A DOUBLE DOSE OF PREGABALIN, as it may cause side effects or worsen mild side effects.
How should I take Pregabalin?
- Tablets: Swallow the Pregabalin tablet whole with water, with or without food, at the same time each day. Do not crush or chew it.
- Liquid or syrup: use a proper measuring device to take the exact dose prescribed. Shake the bottle thoroughly before use and consume at the same time every day, with or without meals.
When Should I take Pregabalin, Before or after food?
You can take Pregabalin with or without food.
Consuming it with food may help reduce side effects like nausea or dizziness.
Tip: Fix a time and take tablet at same time to make it a habit, and then chances of missing the medication is low.
Could this medication have any side effects?
Every medication offers benefits but may also carry the risk of side effects. While most people do not experience serious problems, it’s important to be aware that some individuals may have rare but severe reactions. Knowing what to watch for helps you respond quickly and get the right care if needed. This ensures that any issues can be addressed promptly while you continue to benefit from your treatment.
Adverse Effects
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Adults may feel: dizziness, sleepiness, dry mouth, swelling, blurred vision, weight gain, or trouble focusing.
- Children may have Drowsiness, weight gain, increased appetite.
When taking Pregabalin, is it okay to use other common medications?
When taking Pregabalin, many common medications like paracetamol or ibuprofen are generally safe in moderation. However, combining it with drugs that cause drowsiness—like opioids or sleep aids—can increase side effects such as dizziness or fatigue. It’s important to read medication labels and be aware of potential interactions. If unsure, a pharmacist or doctor can help guide safe choices.
What foods should I avoid while taking Pregabalin?
Pregabalin doesn’t have strict food restrictions, but there are a few things to keep in mind to avoid side effects or reduced effectiveness:
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Alcohol: Increases drowsiness, dizziness, and risk of impaired coordination or breathing issues when combined with Pregabalin.
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High-sugar foods: Pregabalin may cause weight gain and increase appetite, so cutting back on sugary snacks and drinks can help manage this.
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Caffeinated products: May interfere with sleep if you're already experiencing drowsiness or fatigue as a side effect.
- High-sodium processed foods: If you’re prone to swelling (edema), which can be a side effect, salty foods may worsen it.
Pregnancy and Lactation
Pregabalin is not considered completely safe during pregnancy. You should only use Pregabalin while pregnant if your doctor prescribes the medicine after checking risk benefit ratio.
It is best to consult with your doctor before using Pregabalin during pregnancy or breastfeeding.
If I get pregnant while using Pregabalin, is there a risk?
If you get pregnant while taking Pregabalin, it is important to speak with your doctor immediately. Pregabalin is not usually recommended during pregnancy because there is increased risk of birth defects in the baby. Consult doctor immediately, they may suggest stopping the medication or switching to a safer alternative to ensure the best outcome for both you and your baby.
Monitoring Parameters of Pregabalin
- Regular examination of liver enzymes is required.
- Patients with conduction disorders, sodium channelopathies, or other cardiac diseases should have an ECG before starting medication.
How to cope up with side effects of Pregabalin?
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Drowsiness/Dizziness: Avoid driving, get up slowly, and take it at night if needed.
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Weight Gain: Eat healthy, stay active, and limit sugary or salty foods.
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Swelling: Reduce salt, elevate your legs, and stay mobile.
- Blurred Vision/Nausea: Take with food and rest your eyes if needed.
Heart rhythm changes and severe allergic reaction – immediately seek medical attention
Summary
Pregabalin is a medicine used for nerve pain, anxiety, and some seizures. It works by calming overactive nerves. Doctors also give it for problems like fibromyalgia, nerve pain from diabetes, and anxiety. It can help well but may cause giddiness, sleepiness, weight gain, or swelling. Always take it only with a doctor’s advice
Let us know if this information was useful!
Author:
- Dr. Likitha B S, Pharm. D, Clinical Pharmacologist, Aster Hospitals, Bengaluru
- Dr Praveen Kumar, B. Pharm, Pharm D(PB), Lead Clinical Pharmacologist, REGIONAL HEAD KIMS Hospitals, Bengaluru
- Dr. C. P. Ravi Kumar Lead & Senior Consultant – Paediatric Neurology KIMS HOSPITALS BENGALURU