Lyrica |
Pregabalin is an anticonvulsant drug used for neuropathic pain, as an adjunct therapy
for partial seizures. It has also been found effective for generalized anxiety
disorder. It was designed as a more potent successor to gabapentin. Pregabalin
is marketed by Pfizer under the trade name Lyrica. Recent studies have shown that pregabalin is effective at treating chronic pain in disorders such as fibromyalgia[1] and spinal cord injury. In June 2007, pregabalin became the first medication approved by the U.S. Food and Drug Administration specifically for the treatment of fibromyalgia. It is considered to have a low potential for abuse, and a limited dependence liability if misused, and is thus classified as a Schedule V drug in the U.S. History Pregabalin was initially developed by medicinal chemist Richard Bruce Silverman at Northwestern University in the United States. The drug was approved in the European Union in 2004. Pregabalin received U.S. Food and Drug Administration (FDA) approval for use in treating epilepsy, diabetic neuropathy pain and post-herpetic neuralgia pain in June 2005, and appeared on the U.S. market in fall 2005. In June 2007 the FDA approved Lyrica as a treatment for Fibromyalgia Syndrome (FMS). It is the first drug to be approved for treatment of this condition. Pharmacology Like gabapentin, pregabalin binds to the a2d subunit of the voltage-dependent calcium channel in the central nervous system. However, the exact mechanism of action is unknown. Clinical use Indications Pregabalin is indicated for: Treatment of neuropathic pain in adults Adjunctive therapy in adults with partial seizures with or without secondary generalization Fibromyalgia pain. The FDA has approved Pregabalin as an indicated use on June 21, 2007[3] Generalized anxiety disorder (approved in the European Union). Adverse effects Adverse drug reactions associated with the use of pregabalin include: Very common (>10% of patients): dizziness, drowsiness Common (1–10% of patients): visual disturbance (including blurred vision, diplopia), ataxia, dysarthria, tremor, lethargy, memory impairment, euphoria, weight gain, constipation, dry mouth, peripheral edema, loss or decrease of libido, erectile dysfunction Infrequent (0.1–1% of patients): depression, confusion, agitation, hallucinations, myoclonus, hypoaesthesia, hyperaesthesia, tachycardia, excessive salivation, sweating, flushing, rash, muscle cramp, myalgia, arthralgia, urinary incontinence, dysuria, thrombocytopenia, Kidney calculus Rare (<0.1% of patients): neutropenia, first degree heart block, hypotension, hypertension, pancreatitis, dysphagia, oliguria, rhabdomyolysis Drug interactions No pharmacokinetic interactions have been demonstrated in vivo. The manufacturer notes some potential pharmacological interactions with oxycodone, lorazepam and ethanol (alcohol). Concurrent use may increase the central nervous system effects of these medications (e.g. drowsiness, effects on concentration).[ |