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Factors associated with pregabalin dispensing at higher than the approved maximum dose

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

Concerns have been raised about the abuse potential of pregabalin. Therefore, the aim of our study was to characterize patients dispensed pregabalin at higher than the maximum allowed dose in a cohort study based on data extracted from Swedish national registers.

Methods

All patients dispensed at least three prescriptions of pregabalin between July 2006 and December 2009 were included (n = 48,550). The daily dose was defined as the amount of pregabalin dispensed divided by the number of days between the second and third dispensings. Associations between sociodemographic and clinical variables and dispensing pregabalin at a dose exceeding the maximum daily allowed dose (600 mg) were investigated in multivariate regression models.

Results

Of the patients dispensed pregabalin during the study period, 8.5 % were dispensed a dose that exceeded the maximum daily allowed dose. A previous addictive disorder drug treatment or diagnosis was present in 20 and 31 % of patients dispensed pregabalin within and exceeding the recommended dose range, respectively. Our analysis revealed that those patients at increased risk of being dispensed pregabalin at higher than the maximum allowed dose were male [adjusted odds ratio (aOR) 1.40, 95 % confidence interval (CI) 1.31–1.49], were between 18 and 29 years of age compared with those aged ≥65 years (aOR 1.62, 95 % CI 1.45–1.82), had a low income (aOR 1.24, 95 % CI 1.10–1.40), had epilepsy compared with no diagnosis (aOR 1.41, 95 % CI 1.10–1.81), had a previous substance use disorder treatment or diagnosis (aOR 1.41, 95 % CI 1.31–1.52) or had previously been dispensed high doses of drugs with abuse potential (aOR 1.77, 95 % CI 1.62–1.94).

Conclusion

Based on our results we conclude that patients at a high risk of addiction and patients with epilepsy are more likely to be dispensed pregabalin at higher than the maximum approved daily dose.

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Conflict of Interest

The study was independently developed from a project initiated and partially funded by Pfizer, Sweden. Pfizer had no further role in the study design, in the collection, analysis and interpretation of data, in the writing of the report nor in the decision to submit the paper for publication. The authors declare no personal potential conflicts of interest.

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Authors and Affiliations

  1. Centre for Pharmacoepidemiology at the Department of Medicine, Karolinska Institutet, Stockholm, Sweden

    Robert Bodén, Björn Wettermark, Lena Brandt & Helle Kieler

  2. Unit of Psychiatry, Department of Neuroscience, Uppsala University, Uppsala, 751 85, Sweden

    Robert Bodén

Authors
  1. Robert Bodén
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  2. Björn Wettermark
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  3. Lena Brandt
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  4. Helle Kieler
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Correspondence to Robert Bodén.

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Bodén, R., Wettermark, B., Brandt, L. et al. Factors associated with pregabalin dispensing at higher than the approved maximum dose. Eur J Clin Pharmacol 70, 197–204 (2014). https://doi.org/10.1007/s00228-013-1594-5

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  • DOI: https://doi.org/10.1007/s00228-013-1594-5

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