PREGA HY-M CAP

• Pregabalin binds to calcium channel subunits in the central nervous system, reducing the abnormal nerve signalling that causes burning and shooting pain.
• Neuropathic pain responds poorly to ordinary analgesics; pregabalin acts on the mechanism generating the pain instead.
• Methylcobalamin is the active coenzyme form of vitamin B12, involved directly in myelin formation and nerve repair.
• Pregabalin also improves the disturbed sleep and anxiety that commonly accompany chronic nerve pain.
• Effect is usually apparent within the first week, faster than with several alternatives.

Not everyone gets these. Most are mild and settle as the course finishes.

• Pregabalin is a controlled drug in many countries and carries a real risk of misuse and dependence, particularly in patients with a history of substance misuse. Prescribe and dispense accordingly.
• Never stop abruptly after regular use — taper under supervision to avoid withdrawal symptoms including anxiety, insomnia, nausea and sweating.
• Pregabalin combined with opioids causes profound sedation and respiratory depression and has caused deaths. Avoid the combination or use with close monitoring.
• Causes marked drowsiness and dizziness, particularly when starting or increasing the dose. The patient must not drive or operate machinery until the effect is known.
• Dose reduction is required in renal impairment, as pregabalin is renally cleared — this is frequently overlooked in diabetic patients with nephropathy.
• Use with particular caution in the elderly, who are more susceptible to sedation, confusion and falls.
• Avoid alcohol entirely, and use with caution in heart failure, where fluid retention can worsen it.
• Contraindicated in pregnancy unless clearly necessary; use in breastfeeding only on medical advice.