Pregabalin

What it is

Pregabalin binds the alpha-2-delta subunit of voltage-gated calcium channels, damping the release of excitatory neurotransmitters in overactive neural circuits. Compared with gabapentin its absorption is more predictable. It is used for neuropathic pain, and for generalised anxiety where the label carries that indication — in Japan the PMDA label does not.

A usual adult range, not a national label — the dose and the timing differ by country and by product.

Used for

• Neuropathy
• Anxiety

Approved uses differ by country — some of these may be off-label or unapproved where you live.

What to know while taking it

It works with or without food. Sedation, dizziness and blunted concentration are the usual early effects and are amplified by alcohol and other sedating medicines, so driving and machinery need care until the response is clear. Appetite increase, weight gain and fluid retention appear in some people over the longer term. Pregabalin is cleared by the kidneys, so creatinine and eGFR are followed and matter more as kidney function declines. It carries genuine dependence potential — craving, dose escalation and misuse are documented — and stopping suddenly can cause insomnia, sweating, nausea, anxiety or seizures, so changes belong with the prescriber.

When to see a doctor

See a doctor for swelling of the legs or a rapid unexplained gain in weight, for breathing that becomes slow or laboured, or for a rash, blisters or facial swelling. Worsening mood, thoughts of self-harm, or a sense of needing more of the drug than prescribed also warrant a conversation.

Worth knowing

• Causes drowsiness
• Care when driving
• Can cause dependence
• Can change body weight
• Do not stop abruptly

Markers to watch

• Creatinine
• eGFR