Drug

Lyrica®

Explanation / definition

Lyrica ® originally comes from the pharmacotherapeutic group of drugs against epilepsy (anti-epileptic drugs). The active ingredient name is pregabalin. In pain therapy, the main area of application is neuropathic pain (nerve pain).

Trade names

Lyrica ® is a registered trade name of Pfizer.

Chemical name

Pregabalin ((S) -3- (aminomethyl) -5-methylhexanoic acid)

application areas

Neuropathic pain

Lyrica is used as an atypical pain reliever for peripheral nerve pain (neuropathic pain) in adulthood.
These include, for example, diabetic polyneuropathy, postherpetic neuralgia, but also other forms of polyneuropathy, as well as chronic pain syndrome and fibromyalgia. Lyrica is also occasionally used to treat lumbar sciatica (back and leg pain).

epilepsy

Lyrica® is used as add-on therapy for partial seizures with and without secondary generalization in epilepsy in adulthood.

effect

Pregabalin binds to a certain subunit of voltage-dependent calcium channels on nerve cell membranes and thus influences the influx of calcium into the nerve cell. By reducing the influx of calcium, nervous overexcitation states are throttled, which is beneficial for chronic ones Painful conditions affects.

Further information on this topic: Effects of Lyrica

dosage

According to the manufacturer, the daily dose is between 150 and 600 mg and is divided into 2-3 individual doses a day.
Lyrica® can be taken with or without food.
The effect of a Lyrica® therapy can already set in on the second day of treatment.

Excretion is mainly unchanged via the kidneys. A dose adjustment is therefore not necessary in the case of impaired liver function.

In the treatment of epilepsy, Lyrica® is used as an additional medication in partial epileptic cases that are otherwise difficult to treat. The maximum dose is also 600mg per day, which is also divided into 2-3 single doses.

With overdoses of up to 15 g (according to the manufacturer), no unexpected adverse events were reported.

Lyrica® should be discontinued within a week by gradually reducing the dose.

Dosage for neuropathic pain

To treat neuropathic pain (Damage to nerves) Lyrica® is also used.
In consultation with the attending physician, therapy usually begins with a daily dose of 150 mg. This is taken in single doses two to three times a day (e.g. 2x75mg / 3x50mg). It should be taken at the same intervals (morning, afternoon, evening).

The dose can be increased if the effect is absent or insufficient. This increase takes place slowly. Usually the dose is increased after a week at the earliest (300 mg). Then you wait a few days to see how the drug works and how the body gets used to the increased dose before you can increase the dose again (600mg). The maximum dose of 600 mg should not be exceeded during therapy.

Side effects

In most cases, Lyrica® is a well-tolerated drug. The most common side effects are mild to moderate drowsiness and sleepiness (> 1/10).There are also (> 1/100 and <1/10):

Increased appetite, weight gain
Confusion, irritability, decreased libido (sexual potency), euphoria
Blurred vision
Attention disorder
dizziness
Dry mouth, constipation, vomiting, flatulence (wind)
Erectile dysfunction
Edema (water retention), feeling drunk, tired, gait disorders
Muscle aches
Weight loss

Apart from the undesirable effects of the active ingredient pregabalin, Lyrica®, like any drug, can trigger an allergic reaction. This manifests itself in particular through swellings, e.g. in the face or neck area, or extensive reddening of the skin. Lyrica®, or the active ingredient pregabalin, can also cause a number of side effects. This can be traced back to the fact that pregabalin mimics one of the body's own neurotransmitters, which takes on important functions.

Visual disturbances and drowsiness, which can lead to accidents, are particularly dangerous and should therefore be emphasized. Common Lyrica® adverse effects include many forms of changes in consciousness and feelings such as

euphoria
Disorientation
Declining attention
irritability
Memory problems
Memory loss
Joint pain
Sore throat

For other, less common side effects, refer to the Lyrica® package insert. If side effects occur, a doctor or pharmacist should be consulted (not only, but especially if the side effects are serious or very stressful).

Side effect weight loss

An uncommon side effect of Lyrica® is weight loss, which affects about 1 in 100 people.
This arises from the increasing development of anorexia in the course of the therapy. However, the exact mechanism has not yet been clarified.

By far the more common side effect of Lyrica therapy is weight gain.

Side effect weight gain

Often, in the course of therapy with Lyrica®, weight gain occurs, which affects about one in ten people.
According to a study that was carried out, around 10% of patients gain at least 7% of their body weight within the first three months. This increase in weight occurs mainly at the beginning of therapy and with high doses (600 mg). The exact mechanism is also still unclear - a connection with an increased appetite is suspected.

Weight gain differs from patient to patient. According to patient reports, the increase varies between ten and twenty kilograms. There is usually a slow decrease in weight after stopping the drug.

In diabetic patients, the attending physician should be informed of the weight gain so that the dosage can be changed if necessary.

Side effect on the eye

The side effects of Lyrica® therapy often manifest themselves in the eyes. About one in ten patients is affected by this fact.
Many patients report blurred vision and double vision. In addition, dry, swollen eyes and pain in the eye area are possible. Sometimes patients also report unusual eye movements and restricted reflexes.

After discontinuing Lyrica Therapy®, the side effects usually subside or disappear completely. The side effects on the eye should be taken into account at work and while driving and discussed with the attending physician.

Side effect muscle pain

Another occasional side effect is discomfort in the muscles. It affects one in a hundred patients.
The classic leading symptom is the occurrence of pain in the extremities (Arms and legs) and in the back. In addition, muscle cramps and muscle twitching are possible. Many patients also complain of muscle stiffness, which can make many movement sequences considerably more difficult.

Duration of the side effect

The occurrence and duration of the side effects vary significantly from patient to patient. The side effects listed in the package insert can also be attributed to the interaction with other medications or to the corresponding underlying disease.

The side effects usually persist for the duration of the therapy and only occasionally subside a little over the course of the therapy. For this reason, in the event of severe side effects, you should talk to your doctor about a replacement therapy.
After stopping treatment with Lyrica®, the symptoms usually subside within a short time. In some cases, side effects occurring after stopping the drug can be mistaken for withdrawal symptoms.

Interactions

Interactions with other drugs are not yet known.

Lyrica® can increase the effects of ethanol (alcohol), lorazepam and oxycodone.

Lyrica® and alcohol

During therapy with Lyrica®, alcohol should be avoided in any case. In particular, it is strictly forbidden to take Lyrica® at the same time as alcohol. Lyrica is not metabolized by the human body and is eliminated through the kidneys. A change in effectiveness in the case of alcohol-related damage to the liver is therefore not to be feared.

In addition to the typical symptoms, Lyrica® can massively increase the central dampening effect of alcohol. Typically, alcohol-related headaches and nausea are more pronounced. In addition, in extreme cases, the patient can develop increasing drowsiness (up to a coma) and weak breathing. In this case, the patient should see an emergency room or a doctor immediately.

Lyrica® for anxiety disorder

In addition to the use of Lyrica® for neuropathic pain and epilepsy, it is also used in the therapy of generalized anxiety disorders. In the treatment of anxiety disorders, they represent an alternative to the classically used antidepressants and benzodiazepines.

Generalized anxiety disorders are long-lasting and difficult to treat anxiety or anxiety states. Patients often show general restlessness, states of tension, tiredness, concentration and sleep disorders as well as severe irritability. Only in rare cases does the patient report directly about anxiety.

The advantage of Lyrica® compared to the antidepressants and benzodiazepines used is a lower potential for dependence, a weaker sleep-promoting effect and a faster onset of action. In addition, the sometimes very serious side effects of the above drugs (initial increase in anxiety, sexual dysfunction) can be bypassed by therapy with Lyrica®.
For this reason, you should always talk to your doctor about the benefits and risks of the individual drugs.

Withdrawal from Lyrica®

Typical withdrawal symptoms may occur after discontinuing Lyrica®. These withdrawal symptoms occur in a dose-dependent manner - this means that more symptoms occur, especially with high-dose Lyrica® therapy.
A wide variety of symptoms have been reported. While some patients complain of insomnia, sweating, headaches and nausea, other patients experience nervousness, depression, cramps and typical flu symptoms. When using Lyrica® to treat epilepsy, epileptic seizures may become more frequent when the drug is discontinued.

In order to minimize or avoid the occurrence of withdrawal symptoms, the drug should be dosed gradually. This means that the dose should be gradually reduced over a period of time until the drug is no longer needed. This gradual dosage should always be carried out under the supervision of a doctor.

Contraindications

Who shouldn't take Lyrica®?

Patients with an allergy to the active ingredient pregabalin or other drug components.
Patients with hereditary galactose intolerance
Lapp lactase deficiency patients
Patients with glucose-galactose malabsorption.