DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20150359

A review of the drug pregabalin

N. Manjushree, Ananya Chakraborty, K. Shashidhar, Srinivas Narayanaswamy

Abstract


Pregabalin (PGB) is a well-established anticonvulsant and analgesic agent. The stydy reviewed the mechanism of action, pharmacokinetics, adverse drug reactions, contraindications, and various uses of PGB. Literature search was done to identify the relevant studies. PGB is an antagonist of voltage-gated calcium channels and specifically binds to α2-δ subunit to produce antiepileptic and analgesic activity. It has less protein binding activity and lacks hepatic metabolism. It is unlikely to cause pharmacokinetic drug-drug interactions. It has a wide safety margin and does not require serum drug monitoring. The above-mentioned favorable pharmacological benefits of PGB makes it a first-line or adjunctive therapy in various conditions like diabetic peripheral neuropathy, post-herpetic neuralgia, in partial seizures and generalized anxiety disorders.


Keywords


Pregabalin, Neuropathic pain, Partial seizures, Efficacy, Safety

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References


Tassone DM, Boyce E, Guyer J, Nuzum D. Pregabalin: a novel gamma-aminobutyric acid analogue in the treatment of neuropathic pain, partial-onset seizures, and anxiety disorders. Clin Ther. 2007;29(1):26-48.

Zamani G, Tavasoli A, Zare-Shahabadi A, Rezaei N, Ahmadvand A. Efficacy of pregabalin in childhood refractory partial seizure. Iran J Pediatr. 2014;24(1):100-104.

Verma V, Singh N, Singh Jaggi A. Pregabalin in neuropathic pain: evidences and possible mechanisms. Curr Neuropharmacol. 2014;12(1):44-56.

Arezzo JC, Rosenstock J, Lamoreaux L, Pauer L. Efficacy and safety of pregabalin 600 mg/d for treating painful diabetic peripheral neuropathy: a double-blind placebo-controlled trial. BMC Neurol. 2008;8:33.

Taghdiri MM, Bakhshandeh Bali MK, Karimzadeh P, Ashrafi MR, Tonekaboni SH, Ghofrani M. Comparative efficacy of zonisamide and pregabalin as an adjunctive therapy in children with refractory epilepsy. Iran J Child Neurol. 2015;9(1):49-55.

Micó JA, Prieto R. Elucidating the mechanism of action of pregabalin: a (2)d as a therapeutic target in anxiety. CNS Drugs. 2012;26(8):637-48.

Ben-Menachem E. Pregabalin pharmacology and its relevance to clinical practice. Epilepsia. 2004;45(6):8-13.

Onouchi K, Koga H, Yokoyama K, Yoshiyama T. An open-label, long-term study examining the safety and tolerability of pregabalin in Japanese patients with central neuropathic pain. J Pain Res. 2014;7:439-47.

Mishra S, Bhatnagar S, Goyal GN, Rana SP, Upadhya SP. A comparative efficacy of amitriptyline, gabapentin, and pregabalin in neuropathic cancer pain: a prospective randomized double-blind placebo-controlled study. Am J Hosp Palliat Care. 2012;29(3):177-82.

Zaccara G, Almas M, Pitman V, Knapp L, Posner H. Efficacy and safety of pregabalin versus levetiracetam as adjunctive therapy in patients with partial seizures: a randomized, double-blind, noninferiority trial. Epilepsia. 2014;55(7):1048-57.

Dou Z, Jiang Z, Zhong J. Efficacy and safety of pregabalin in patients with neuropathic cancer pain undergoing morphine therapy. Asia Pac J Clin Oncol. 2014;10:12311.

Razazian N, Baziyar M, Moradian N, Afshari D, Bostani A, Mahmoodi M. Evaluation of the efficacy and safety of pregabalin, venlafaxine, and carbamazepine in patients with painful diabetic peripheral neuropathy. A randomized, double-blind trial. Neurosciences (Riyadh). 2014;19(3):192-8.

Moon DE, Lee DI, Lee SC, Song SO, Yoon DM, Yoon MH, et al. Efficacy and tolerability of pregabalin using a flexible, optimized dose schedule in Korean patients with peripheral neuropathic pain: a 10 week, randomised, double blind, placebo-controlled, multicentre study. Clin Ther. 2010;32(14):2370-85.

Toth C. Pregabalin: latest safety evidence and clinical implications for the management of neuropathic pain. Ther Adv Drug Saf. 2014;5(1):38-56.

Arnold LM, Emir B, Murphy TK, Zeiher BG, Pauer L, Scott G, et al. Safety profile and tolerability of up to 1 year of pregabalin treatment in 3 open-label extension studies in patients with fibromyalgia. Clin Ther. 2012;34(5):1092-102.

Kustermann A, Möbius C, Oberstein T, Müller HH, Kornhuber J. Depression and attempted suicide under pregabalin therapy. Ann Gen Psychiatry. 2014;13(1):37.

Smith TL, Baldwin A, Cunningham LL Jr, Cook AM. Rash associated with pregabalin use. Ann Pharmacother. 2008;42(12):1899-902.

Shneker BF, McAuley JW. Pregabalin: a new neuromodulator with broad therapeutic indications. Ann Pharmacother. 2005;39(12):2029-37.

Blommel ML, Blommel AL. Pregabalin: an antiepileptic agent useful for neuropathic pain. Am J Health Syst Pharm. 2007;64(14):1475-82.

Moore RA, Straube S, Wiffen PJ, Derry S, McQuay HJ. Pregabalin for acute and chronic pain in adults. Cochrane Database Syst Rev. 2009:CD007076.

Montgomery SA. Pregabalin for the treatment of generalised anxiety disorder. Expert Opin Pharmacother. 2006;7(15):2139-54.

Ziyaeifard M, Mehrabanian MJ, Faritus SZ, Khazaei Koohpar M, Ferasatkish R, Hosseinnejad H, et al. Premedication with oral pregabalin for the prevention of acute postsurgical pain in coronary artery bypass surgery. Anesth Pain Med. 2015;5(1):e24837.