Naxalgan (Pregabalin)

Pregabalin is employed to treat conditions involving neuropathic pain, seizures, and anxiety.

• Diabetic peripheral neuropathic pain: reduces pain intensity and improves sensory function.
• Postherpetic neuralgia: alleviates chronic burning and stabbing pain after shingles.
• Fibromyalgia: lessens widespread musculoskeletal pain and fatigue.
• Partial onset seizures: decreases seizure frequency in adults.
• Generalized anxiety disorder: diminishes excessive worry and associated symptoms.

• 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, seizures, and anxiety.

Pregabalin may cause a range of adverse reactions, varying 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.

Serious or Rare Side Effects

• Angioedema: rapid swelling of face, lips, tongue, or throat.
• Severe hypersensitivity: rash, itching, or anaphylactic reactions.
• Suicidal thoughts: emergence of depressive symptoms or suicidal ideation.

Before prescribing Naxalgan, clinicians should consider several safety aspects.

• Renal impairment: dose adjustment may be required in patients with reduced kidney function.
• Elderly patients: monitor for increased dizziness or falls.
• Concomitant CNS depressants: avoid excessive sedation when combined with alcohol or opioids.
• Pregnancy and lactation: use only if the potential benefit justifies the potential risk to the fetus or infant.
• Store at ambient temperature: keep below 25°C in the original packaging, protected from moisture and direct sunlight.

Pregabalin can interact with other medicines, affecting efficacy or safety.

Major Interactions (Avoid)

• Opioids: combined use may cause profound respiratory depression and profound sedation.
• CNS depressants (e.g., benzodiazepines): may result in excessive drowsiness or impaired coordination.

Moderate Interactions (Monitor Closely)

• Antihypertensives: pregabalin may enhance blood‑pressure‑lowering effects.
• Diuretics: monitor for increased risk of peripheral edema.
• ACE inhibitors or ARBs: watch for additive effects on renal function in susceptible patients.