Naxalgan (Pregabalin)

Pregabalin is indicated for several neurological and pain‑related conditions.

• Neuropathic pain: reduces pain intensity in diabetic peripheral neuropathy and post‑herpetic neuralgia.
• Fibromyalgia: alleviates widespread musculoskeletal pain and improves functional capacity.
• Partial seizures: used as adjunct therapy to control focal onset seizures.
• Generalized anxiety disorder: decreases anxiety symptoms in adult patients.

• Pregabalin binds selectively to the α2‑δ subunit of voltage‑gated calcium channels in the central nervous system. This binding reduces calcium influx into presynaptic neurons, which in turn decreases the release of excitatory neurotransmitters such as glutamate, norepinephrine, and substance P, leading to diminished neuronal hyperexcitability associated with pain and seizure activity.

Pregabalin may cause a range of adverse reactions, from mild to serious.

Common Side Effects

• Dizziness: sensation of light‑headedness or unsteadiness.
• Somnolence: increased sleepiness or fatigue.
• Peripheral edema: swelling of the lower extremities.
• Weight gain: gradual increase in body weight.
• Blurred vision: temporary visual disturbances.
• Dry mouth: reduced salivary flow.

Serious or Rare Side Effects

• Angioedema: rapid swelling of face, lips, tongue, or throat.
• Severe rash or Stevens‑Johnson syndrome: extensive skin reactions.
• Suicidal thoughts or behavior: new or worsening mood changes.
• Respiratory depression: slowed breathing, especially with CNS depressants.
• Hypersensitivity reactions: anaphylaxis or severe allergic response.
• Blood dyscrasias: rare cases of leukopenia or thrombocytopenia.

When prescribing or dispensing Pregabalin, several safety considerations are important.

• Renal impairment: adjust dose based on creatinine clearance.
• Pregnancy: discuss potential risks with a healthcare professional; data are limited.
• CNS depression: avoid concomitant alcohol or sedatives that may enhance drowsiness.
• Suicidality: monitor patients for mood changes or emergent suicidal thoughts.
• Withdrawal: taper gradually to reduce the risk of rebound symptoms.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Pregabalin can interact with other medicines, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• Opioids: combined use may increase risk of respiratory depression.
• CNS depressants (e.g., benzodiazepines): may enhance sedation and dizziness.
• Antacids containing aluminum or magnesium: can reduce Pregabalin absorption.

Moderate Interactions (Monitor Closely)

• NSAIDs: concurrent use may heighten risk of renal impairment.
• Diuretics: may increase serum Pregabalin concentrations.
• Antihypertensives: potential additive hypotensive effect.