Lyrica (Pregabalin)

What is Lyrica?

Lyrica is a prescription-only medication widely used to manage nerve pain, fibromyalgia, and generalized anxiety disorder (GAD). It is also prescribed as an add-on treatment for adults experiencing partial-onset seizures.

It belongs to a class of drugs known as gabapentinoids. While pregabalin is structurally similar to the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), it does not bind to GABA receptors directly. Instead, it works by binding to calcium channels in the central nervous system to reduce the release of pain and anxiety-inducing neurotransmitters.

Generic Names:

• Pregabalin: The active chemical name used worldwide.

Global Brand Names:

Pregabalin is distributed under several brand names globally and in Hong Kong.

• Lyrica (利痛抑): The original brand by Viatris, widely available in capsule and oral solution forms.
• Pregabalin Sandoz: A common generic alternative available in various capsule strengths.
• Gaba: A locally registered generic pregabalin formulation.

These names all refer to the same medication. It's important to note that while the active ingredient is the same, different countries may have different regulations and available medication formulations.

What is Lyrica used for?

Lyrica is used to relieve:

• Neuropathic pain (nerve pain) from diabetes, shingles, or spinal cord injury
• Fibromyalgia
• Generalized anxiety disorder (GAD)
• Partial-onset seizures in adults

How do you use Lyrica?

Availability:

• Capsules
• Oral solution

Dosage Information:

• Adults: Usually starts at 150 mg per day, divided into two or three doses, up to a maximum of 600 mg per day based on the specific condition.
• Elderly: May require lower starting doses due to age-related changes in kidney function.

Suitability:

• Adults: Yes
• Elderly: Yes, with caution and possible dose adjustments.
• Infants/Children: No, typically not recommended unless specifically prescribed by a specialist.

Who cannot take Lyrica?

Allergies and unsuitability:

• Rare, but possible severe allergic reactions, including angioedema.

Conditions where the drug should not be used:

• Known allergy to pregabalin

Common side effects of Lyrica include dizziness, sleepiness, dry mouth, blurred vision, weight gain, and swelling in the hands or feet. Some patients may also experience difficulty concentrating or feeling 'brain fog' when initiating the medication.

Severe adverse reactions are rare but include significant hypersensitivity reactions like swelling of the face and throat, severe respiratory distress, and an increased risk of suicidal thoughts. Overuse or abrupt discontinuation without a tapering schedule can lead to withdrawal symptoms such as insomnia, headache, nausea, and severe anxiety.

• Do not stop taking abruptly to avoid withdrawal symptoms such as insomnia and nausea.
• Do not exceed the prescribed dose to prevent an increased risk of severe dizziness and respiratory depression.
• Avoid alcohol to reduce the risk of extreme drowsiness and breathing difficulties.
• Check with a doctor if you are taking opioids, as the combination significantly increases the risk of fatal respiratory depression.
• Check with a doctor if you take lorazepam or ACE inhibitors to prevent compounded side effects.

Storage information:

• Keep in a cool, dry place at controlled room temperature (15°C to 30°C).
• Store safely out of reach of children.

Handling instructions:

• Swallow capsules whole with a glass of water.
• Use the measuring device that comes with the oral solution for the correct dose rather than a household spoon.

Where is Lyrica available in Hong Kong?

In Hong Kong, Lyrica and its generic pregabalin alternatives are classified as a Prescription Only Medicine. You must present a valid doctor's prescription to purchase it legally.

This medication can be obtained at hospital and clinic pharmacies, as well as registered community dispensaries displaying the 'Rx' logo. It must be dispensed under the direct supervision of a registered pharmacist.