Epilepsy is a serious, incurable disease. But thanks to the development of modern medicine and pharmacology, there are many drugs that not only help fight convulsive seizures, but also practically reduce them to nothing. It is this drug that is Pregabalin.
With status epilepticus, it is often used as a complex therapy along with other anticonvulsant drugs to achieve a better effect. The instructions for use provided below will help to understand the prescriptions, as well as the pharmacological properties and rules for the safe use of Pregabalin.
General information about the drug
Pregabalin is a derivative of gamma-aminobutyric acid. Refers to antiepileptic drugs with anti-anxiety action. Specialists also note the ability of the drug to eliminate chronic pain with fibromyalgia and / or spinal cord injuries.
Medicinal group, INN, scope
Before starting therapy, it is important to understand what kind of drug it is. Anticonvulsants-info.com belongs to the antiepileptic drug group. INN – Pregabalin. The drug is widely used along with other anticonvulsant medicines for seizures and helps patients with an epileptic status to minimize the number of seizures, and sometimes completely remove them.
The medicine is also taken as monotherapy by people with chronic neuropathic pains of various origins, which greatly facilitates their condition. This drug has also been shown to be effective in anxiety disorders of personality.
Forms of release and prices for the drug
It is available in the form of gelatin capsules of white-orange color, with marking in the form of numbers that display the amount of active substance in the composition. Due to the appearance of the capsules, they are mistaken for tablets. One cardboard package contains 2 or 8 blisters, 7 capsules in each. Released by prescription.
The price of Pregabalin depends on the concentration of the active substance in 1 capsule of the drug and the number of blisters in the package.
Structure
The name of the main component coincides with the name of the drug – pregabalin. This substance has an anticonvulsant effect, relieves neuropathic pain and helps with anxiety disorder.
The medication is available in different concentrations, where 1 capsule may contain 75, 150, 225 or 300 mg of the active substance. Regular and pregelatinized corn starch, lactose monohydrate, talc, beckon, gelatin and shellac are auxiliary components of the composition.
Pharmacodynamics and pharmacokinetics
Pregabalin has an anticonvulsant and analgesic effect, due to its ability to bind to voltage-dependent calcium channels in the central nervous system using an auxiliary subunit.
The absorption period is small, especially when taken on an empty stomach. Bioavailability is high, more than 90%. The dose of a substance has no effect on it. Communication with proteins is absent. It is practically not metabolized in the body, so more than 98% of the substance is excreted by the kidneys unchanged.
The half-life for healthy middle-aged people is about 6 hours (plus or minus 30 minutes), when for children under the age of 6 it takes only 3-4 hours, and from 7 years of age it takes 4-6 hours. Half-life in people over 65 years of age is significantly slowed down, which is necessarily taken into account when choosing a dosage.
The substance passes through the placenta to the fetus and passes into the woman’s breast milk unchanged. The percentage of the substance in human milk is approximately 67%. The medication does not affect the woman’s ability to give birth.
Indications and contraindications
The drug has an effective therapeutic effect in:
- epilepsy;
- neuropathic pain;
- fibromyalgia;
- generalized anxiety disorder.
Allergic manifestations on the components of the composition make it impossible to treat with this medication. Pregabalin is not recommended for children until adulthood, since the effect of the drug on the children’s body has not been fully studied.
Kidney dysfunction can significantly slow down the removal of a substance from the body. Therefore, people with kidney failure should take this medication with extreme caution. In patients with chronic heart failure, Pregabalin can exacerbate an already poor heart condition.
For people with a medical or drug dependence in the history of the drug should be used only under the supervision of a doctor.
Studies on the safety of Pregabalin for pregnant women have not been conducted. There is also no data on the effect of the substance on the fetus and the body of the newborn. Prescribing a medication to pregnant women is possible only in extreme cases, when the benefit for the mother significantly exceeds the possible risks for the child. Due to the lack of data on the effect of the drug on the child with HB, women are advised to abandon breastfeeding at the time of therapy.
People who are predisposed to suicidal moods, Pregabalin is contraindicated, since its use can only increase the patient’s desire for suicide.
Dosage and administration
Appointed inward. The dose is directly proportional to the presence of other concomitant pathologies in the patient. On average, the recommended daily dose is divided into 2-3 doses and ranges from 150-600 mg.
In epilepsy, the initial daily dose is not more than 150 mg. The dose does not increase more than once every 7 days. The upper limit of the possible daily dose is 600 mg. For anxiety disorders, the first week of therapy, the dose is also 150 mg. Each week, the dose can be increased exactly by the amount of substance at the first dose. The need to take Pregabalin with an increased sense of anxiety is periodically reviewed.
Patients with fibromyalgia and neuropathic pain on average take from 300 to 450 mg of the substance per day, breaking the dose into 2 doses. If a dose of 450 mg is ineffective, it is recommended to choose another drug. Since bringing the daily dose to maximum values (600 mg) for these diseases will not bring the desired therapeutic result.
The substance is excreted mainly by the kidneys, so patients with their dysfunction need to select a dose individually, taking into account creatine clearance indicators. Patients who undergo a hemodialysis procedure for 4 hours or more are prescribed an additional single dose equal to 25 mg of the active component.
Possible side effects and overdose
Taking the drug can cause a number of complications, among which dizziness and fatigue are most common. Basically, the appearance of side effects is associated with the presence of concomitant diseases in the patient.
More often than others, the following adverse reactions appear:
- pharyngitis;
- neutropenia;
- changes in appetite;
- allergic reactions (anaphylactic shock, urticaria, itching);
- euphoria;
- violation of consciousness and orientation in space;
- irritability and aggressiveness;
- sleep disturbance;
- oppression of sexual desire;
- deterioration or loss of short-term memory;
- tremor of limbs;
- encephalopathy;
- lethargy;
- lethargic sleep and coma;
- stupor;
- visual impairment;
- conjunctivitis;
- pain in the eyes;
- photophobia;
- hemorrhage in the eye;
- vertigo;
- heart palpitations and heart rhythm disturbances;
- heart failure;
- AV block;
- respiratory failure;
- nosebleeds;
- cough;
- vomiting
- constipation and flatulence;
- pain in the back and limbs;
- cramping neck pain;
- impotence;
- violation of walking;
- fluid retention;
- fast fatiguability;
- increased blood glucose.
When using the drug in high doses, the following symptoms of overdose arise:
- nausea with vomiting;
- dizziness and loss of consciousness;
- drowsiness;
- irritability
- confusion of consciousness;
- convulsive seizures;
- coma.
Detoxification is carried out by removing the drug from the stomach by washing and prescribing activated carbon. Perhaps the appointment of symptomatic therapy and hemodialysis.
Interaction with other drugs
Pregabalin does not bind to blood proteins and does not break down into metabolites, therefore, it practically does not interact with other medicines.
According to studies, phenobarbital, topiramate, diuretics and insulin, as well as all oral antidiabetic drugs, absolutely do not affect the therapeutic effect of Pregabalin and its concentration in the body.
Does not affect the effectiveness of contraceptives for oral use. In rare cases, pregabalin can enhance the effect of ethanol, lorazepam, and CNS depressants. Such combinations are fraught with the development of respiratory failure and can lead to coma.
Parallel administration of the drug with opioid painkillers and other medications that slow down the motility of the lower gastrointestinal tract can cause constipation and intestinal obstruction. Hemodialysis accelerates drug excretion by 50%, so you may need to take an additional single dose of 25 mg of Pregabalin.
Patients with an epileptic status take Pregabalin as a complex treatment along with other drugs for epileptic seizures, which only enhance its effect and do not affect the incidence of side effects. Antispastic agents enhance the effect of the drug and increase the likelihood of complications from the central nervous system.
Special instructions
It is important to consider the following features of the drug during therapy to minimize the risk of negative consequences:
- The drug can cause dizziness and drowsiness, so during its administration it is worth refraining from driving any vehicle and from work that requires a quick reaction, increased attention and concentration.
- With a sharp rejection of this drug, withdrawal syndrome may develop, which is characterized by the appearance of headache, irritation, vomiting, insomnia, dyspeptic disorders, seizures and depression. The number and strength of the manifestation of complications directly depends on the daily dose of the drug. In this regard, the use of this drug is stopped by gradually reducing the dose.
- Pregabalin can cause overweight in people with diabetes. In this case, the dose of hypoglycemic drugs is adjusted.
- In case of severe allergic reactions, such as anaphylactic shock, swelling of the upper respiratory tract or face, it is urgent to stop taking the drug and call emergency care.
- While taking the medication, some patients suffer from loss of consciousness, which leads to accidental injuries. The specialist should warn of this probability and recommend that he is at home until it is found out how the body reacts to the drug.
- The medication in the first days of admission can cause temporary visual impairment. With prolonged use of the drug, clarity of vision, as a rule, returns to normal. Pregabalin gives a large burden on the kidneys, which is fraught with the development of renal failure. After the drug is canceled, the function of the organ is restored.
- Pregabalin alone is not enough to completely relieve seizures in epilepsy. The drug can cause congestive heart failure in patients with concomitant diseases of CVS.
- Patients with spinal cord injuries are more prone to adverse reactions from the central nervous system. This reaction occurs due to the parallel administration of Pregabalin and antispastic agents. This interaction of drugs must be considered when adjusting the dosage.
- People with a history of encephalopathy should take the drug with extreme caution, as this can significantly worsen the general condition of the body. The drug does not affect spermatogenesis even with prolonged use of the maximum dose of the drug.
Analogs
All analogues of the drug contain pregabalin in their composition, only its dosage and auxiliary components differ. The main similar tools include:
- Algerica is a medicine of Croatian manufacture. Releases in opaque, white capsules, containing 75 and 150 mg of active ingredient. Lactose free. Sold in cardboard packages with 1, 2 or 4 blisters, 14 capsules each.
- Gabalin – contains 75, 150 and 300 mg of active ingredient. Release form – capsules, light gray with marking. Not allowed for patients with lactose intolerance, due to its presence in the composition of the drug. Country of manufacture – Turkey.
- Galara is a Turkish anticonvulsant drug based on pregabalin (75 and 150 mg in 1 capsule). Lactose in the composition is absent.
- Zonic – capsules containing 150 mg of the active ingredient. Made in India.
- Lingbag is an analogue that has a wide selection of the concentration of the main substance. One capsule may contain 25, 50, 75, 100, 150, 200, 225, or 300 mg pregabalin. The drug is produced in Slovenia. The medication is convenient to use for people who, for one reason or another, are allowed a small dose of the drug. Lactose free.
- Lyrica is an anticonvulsant drug co-produced in Germany and the United States. The amount of pregabalin in 1 capsule is from 50 to 300 mg. Not allowed for patients with congenital lactose intolerance. It is available in solid, opaque capsules of white or white-orange color with the marking in the form of the inscription “Pfizer”. It is the most expensive analogue.
- Neurocem – is available in the form of capsules containing white or almost white powder from pregabalin and auxiliary components, in the form of talc, starch and sodium lauryl sulfate. It is made in Ukraine.
- Neogabin is a medicine of Ukrainian production. Release form – gelatin capsules of 75 or 100 mg of active ingredient in each. Capsules contain white powder with possible impregnations in the form of compressed lumps that easily disintegrate.
- Pregabio is another pregabalin-based anticonvulsant drug made in Slovenia. Release form – capsules (hard, gelatin). Has a similar concentration with Lingbag.
Absolutely all similar drugs have an identical list of indications and contraindications, and are also able to cause the same side effects and the identical mechanism of action. The main distinguishing feature of analogues is the use of various auxiliary components. The manufacturer country also differs from analogues, which significantly affects their price category.
Reviews of doctors and patients
Many patients taking Pregabalin, note the appearance of a large number of adverse reactions that significantly affect the general condition of the body. Reviews of specialists about the drug are usually positive. Doctors note that the frequency and severity of adverse reactions can be minimized if all recommendations are followed.
Here are some reviews:
Vasilisa, 23 years old: “A neurologist prescribed this medicine to me, and after taking 1 capsule, horror began, terrible things began to happen to me. At first a severe headache appeared, I began to feel a little nauseous, a strong dry mouth appeared, and, in the end, I began to lose orientation in space. All my relatives were seriously scared, but I didn’t understand much.
If they did not know that I absolutely could not stand alcohol, they would definitely decide that I was drunk. I had never felt so bad before, it seemed to me that I was about to die. Finally let me go only after 2 days. Wasn’t the doctor supposed to warn of such a possible reaction of my body? I am disappointed, I will never take this medicine again. I do not recommend it. ”
Valentina Petrovna, neurologist: “Pregabalin helps to fight seizures with epilepsy as part of complex therapy. I quite often prescribe it to my patients. Moreover, there are many analogues that help you choose the perfect medication for each individual person. The main thing, when prescribing this medication, is to explain in detail the importance of observing the dosage and detail the consequences of its non-compliance.
Any medicine can cause certain complications and call a medication bad, because it has a detrimental effect on certain people, it is simply impractical. Personally, I attribute it to good medicines, of course, with the right dosage selection. “
Pregabalin is an effective anticonvulsant medication that also helps to cope with chronic pain associated with neuralgia and spinal cord injuries. Specialists often prescribe this drug to people with epileptic status and anxiety disorder as a component of complex therapy.
The medicine can cause irreparable harm to health, up to falling into a lethargic sleep or coma if the prescribed dosage is not observed or individual intolerance of the components of the composition. Before starting therapy, it is recommended to inform the attending physician about all existing concomitant diseases in order to avoid complications.