Adis Drug Profile

Drugs & Aging

, Volume 26, Issue 10, pp 883-892

First online:

Pregabalin

In the Treatment of Postherpetic Neuralgia
  • Kate McKeageAffiliated withAdis, a Wolters Kluwer Business Email author 
  • , Susan J. KeamAffiliated withAdis, a Wolters Kluwer Business

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Abstract

  • ▲ Pregabalin is the pharmacologically active S-enantiomer of 3-aminomethyl-5-methyl-hexanoic acid. It has a similar pharmacological profile to that of its developmental predecessor gabapentin, but had greater analgesic activity in rodent models of neuropathic pain.

  • ▲ Pregabalin is thought to act by reducing the excessive release of several excitatory neurotransmitters by binding to the α2-δ protein subunit of voltage-gated calcium channels.

  • ▲ Oral pregabalin 150–600 mg/day, administered in two or three divided doses, was significantly more effective than placebo in relieving pain and improving pain-related sleep interference in four randomized, double-blind, multicentre studies of 4–13 weeks’ duration in patients with postherpetic neuralgia (PHN).

  • ▲ Pregabalin achieved a faster onset of pain relief than placebo. The median times to the onset of pain relief with fixed and flexible doses of pregabalin were 1.5 and 3.5 days compared with <4 weeks with placebo.

  • ▲ Pregabalin was generally well tolerated when titrated over 1 week to fixed dosages (maximum 600 mg/day) in clinical trials in mostly elderly PHN patients. Adverse events were usually mild to moderate in severity.