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Pregabalin - Need to know.

Updated: Jan 21, 2021



Mechanism of action

- Analog of neurotransmitter GABA

- Binds the alpha-2delta unit of calcium channels reducing calcium influx

- Causes reduced release of glutamate, noradrenaline and substance P


Indications

- Diabetic neuropathy


Dosing


Common side effects

- Somnolence

- Dizziness

- Weight gain

- Peripheral oedema

- Ataxia

- Dry mouth


Rare side effects - be aware!

- Rhabdomyolysis

- Acute renal failure

- Hyperthermia

- Secondary acute angle glaucoma


Liver and kidney issues?

- Titrate dose in renal failure

- No changes required in liver failure


Golden pearls

- Does NOT bind GABA receptors and is NOT converted into GABA (Trap!)

- Can improve mood and sleep

- Affects balance so use carefully in elderly/falls risks

- They are considered more benign than the TCAs due to side effect profile


Resources:


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