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Pregabalin

Klassificering: A

Preparat: Brieka, LYRICA®, Pregabalin 1A Farma, Pregabalin Accord, Pregabalin Accord Healthcare, Pregabalin EQL Pharma, Pregabalin Krka, Pregabalin Orion, Pregabalin Ranbaxy, Pregabalin Sandoz, Pregabalin Sandoz GmbH, Pregabalin STADA, Pregabalin Teva

ATC kod: N03AX16

Substanser: pregabalin

Sammanfattning

Pregabalin är indicerat för behandling av neuropatisk smärta, generaliserat ångestsyndrom och som tilläggsbehandling vid partiella anfall. Den antikonvulsiva effekten av pregabalin är likartad mellan könen.

Biverkningsprofilen för pregabalin är likartad mellan könen. Viktökning till följd av pregabalinbehandling är inte kopplat till kön.
 
Kunskapsunderlaget avseende skillnader mellan kvinnor och män är begränsat och motiverar inte olika dosering eller behandling.

Additional information

Pregabalin is indicated for management of neuropathic pain in adults, as adjunctive therapy for partial seizures in adults and as treatment of generalized anxiety disorder.

Pharmacokinetics and dosing

Population pharmacokinetic analyses of the clinical studies showed that the relationship between daily dose and pregabalin drug exposure is similar between women and men [1]. Clinical trials have shown that patient's sex don’t have any clinically significant impact on the plasma concentration of pregabalin [2]. A randomized controlled trial showed that women had a slightly smaller volume of distribution than men. This is not likely to be of clinical significance. Pregabalin oral clearance was independent of sex. The population estimate of Vd/F was dependent on body weight, which was accounted for by sex differences, with women having an approximately 20% lower value than men [3]. Despite the pharmacokinetic differences of pregabalin, the clinical studies have shown effect with similar doses in men and women and no sex differentiation in dosing has been suggested [2].

Effects

The anti-seizure efficacy of pregabalin has no clinically important sex differences, according to the manufacturer [2].

Adverse effects

The overall adverse event profile of pregabalin in clinical trials was similar between women and men, despite indication. Pregabalin associated weight gain has shown to be related to dose and duration of exposure, but did not appear to be associated with baseline BMI, sex or age [2].

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Other information

Pregabalin abuse and dependence has recently been studied in Germany. The analysis was based on cases reported to the database of German medical regulatory body (BfArM) since 2008. The majority of patients identified were men (63.6%). However, there was a small number of cases (n = 55) and data was insufficient [4].

Försäljning på recept

Fler kvinnor än män hämtade ut kapslar innehållande pregabalin (ATC-kod N03AX16) på recept i Sverige år 2015, totalt 29 469 kvinnor och 20 184 män. Det motsvarar 6,0 respektive 4,1 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 75 år och äldre hos båda könen. I genomsnitt var kapslar innehållande pregabalin 1,4 gånger vanligare hos kvinnor [5].

Uppdaterat: 2019-02-26

Litteratursökningsdatum: 2013-03-12

Referenser

  1. Lyrica (pregabalin). DailyMed [www]. US National Library of Medicine. [updated 2013-01-01, cited 2013-03-12]. länk
  2. Lyrica (pregabalin). Summary of Product Characteristics. European Medicines Agency; 2016. länk
  3. Bockbrader HN, Burger P, Knapp L, Corrigan BW. Population pharmacokinetics of pregabalin in healthy subjects and patients with chronic pain or partial seizures. Epilepsia. 2011;52:248-57. PubMed
  4. Gahr M, Freudenmann RW, Hiemke C, Kölle MA, Schönfeldt-Lecuona C. Pregabalin abuse and dependence in Germany: results from a database query. Eur J Clin Pharmacol. 2013;69:1335-42. PubMed
  5. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-04-05.] länk

Författare: Linnéa Karlsson Lind, Desirée Loikas

Faktagranskat av: Expertrådet för neurologiska sjukdomar, Ellen Vinge, Lars Lööf

Godkänt av: Mia von Euler