Pregabalin for neuropathic pain in primary care settings: recommendations for dosing and titration

Pregabalin is one of the first-line treatments approved for management neuropathic pain (NeP). While many patients benefit from treatment with pregabalin, they are often treated suboptimal doses, possibly due to unfamiliarity around prescribing drug and/or side effects that can occur up-titration. This narrative review discusses key aspects initiating, titrating, and managing prescribed pregabalin therapy, addresses concerns driving potential abuse, as well when seek specialist opinion. To ensure derive maximum therapeutic drug, we suggest a ‘low slow’ dosing approach limit common optimize tolerability alongside patients’ expectations. When requiring titration higher recommend initiating ‘asymmetric dosing,’ larger dose in evening. Fully engaging order them understand expected timeline efficacy (including their resolution), also help determine optimal tempo each individual patient. The recognizes NeP heterogeneous terms pregabalin. Hence, it recommended general practitioners closely monitor up-titrate according relief or premature discontinuation.