The Cleveland Clinic Foundation

1.) Pregabalin (Lyrica): Pregabalin is FDA-approved for the management of neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, and as an adjunct therapy for patients with partial-onset seizures. Although it is a structural analogue of gamma-aminobutyric acid (GABA), its exact mechanism is unknown. Common adverse effects associated with pregabalin use include headache, dizziness, fatigue, somnolence, weight gain, and gastrointestinal symptoms. Its use is also associated with peripheral edema; therefore, caution should be used when administering pregabalin concomitantly with other drugs that cause edema (e.g., thiazolidinediones). Pregabalin does not affect the plasma concentrations of other anticonvulsants. Effective doses for treating peripheral neuropathy and epilepsy range from 150 to 600 mg/day. Please refer to product labeling for initial dosing and dose titration recommendations, and for dose adjustments in patients with renal insufficiency. Because pregabalin use resulted in euphoria when studied in recreational drug users, it is ranked as a Schedule V controlled substance. To avoid withdrawal-like symptoms, pregabalin should not be abruptly discontinued rather it should be tapered gradually over a minimum of 1 week. Pregabalin is available as 25-, 50-, 75-, 100-, 150-, 200-, 225-, and 300-mg capsules.