T pregabalin dose
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Here is a summary of pregabalin dosing by indication, drawn from authoritative textbooks:
Pregabalin Dosing by Indication
Neuropathic Pain
| Indication | Dose |
|---|---|
| Postherpetic neuralgia | 50–100 mg TID (150–300 mg/day) |
| Diabetic peripheral neuropathy | 100–200 mg TID (300–600 mg/day) |
| General neuropathic pain | Start 75–150 mg/day, titrate; effective range 300 mg/day (NNT 2.2 for diabetic neuropathy) |
Fibromyalgia
- 450–600 mg/day in divided doses
Generalized Anxiety Disorder (GAD)
- Start: 150 mg/day
- Titrate gradually up to 600 mg/day in 2–3 divided doses
- Note: No consistent dose-response relationship was found; 300 mg/day was more effective than 150 or 450 mg in some studies
Epilepsy (Focal/Partial-Onset Seizures — adjunctive)
- Used as adjunct; standard anticonvulsant dosing applies
Renal Dose Adjustment
- Dose reduction required if CrCl < 60 mL/min
- Reduce dose by ~50% for each additional 50% decrease in CrCl
- Patients on hemodialysis may need supplemental doses after each session (pregabalin is highly dialyzable)
Key Pharmacokinetic Points
- Bioavailability >90%, linear absorption (unlike gabapentin)
- Half-life ~6.5 hours
- Minimal hepatic metabolism (<2%); renally excreted unchanged
- No significant drug interactions (no hepatic enzyme induction/inhibition)
Important Safety Notes
- Do not stop abruptly — risk of severe withdrawal including seizures
- Potentiates CNS depressants (alcohol, benzodiazepines, antihistamines)
- Common side effects: dizziness, somnolence, peripheral edema, blurred vision
- High misuse potential, especially combined with opioids
Available formulations: 25, 50, 75, 100, 150, 200, 225, 300 mg capsules
— Kaplan & Sadock's Synopsis of Psychiatry; Maudsley Prescribing Guidelines, 15th ed.; Bradley & Daroff's Neurology in Clinical Practice
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