Pegamax Capsule
Pregabalin
Indications
Pegamax is indicated for:
- Neuropathic pain associated with diabetic peripheral neuropathy (DPN)
- Postherpetic neuralgia (PHN)
- Adjunctive therapy for the treatment of partial-onset seizures in patients 1 month of age and older
- Fibromyalgia
- Neuropathic pain associated with spinal cord injury
Pegamax CR tablet is indicated for:
- Neuropathic pain associated with diabetic peripheral neuropathy (DPN)
- Postherpetic neuralgia (PHN)
Pharmacology
Pregabalin is a structural derivative of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). It does not bind directly to GABAA, GABAB or benzodiazepine receptors. Pregabalin binds with high affinity to the alpha2-delta site (an auxiliary subunit of voltage-gated calcium channels) in central nervous system tissues. Although the mechanism of action of Pregabalin has not been fully elucidated, results in animal studies suggest that binding to the alpha2-delta subunit may be involved in Pregabalin’s anti-nociceptive and antiseizure effects.
Dosage
Neuropathic pain associated with diabetic peripheral neuropathy in adults (DPN): The maximum recommended dose of Pregabalin is 100 mg three times a day (300 mg/day) in patients with creatinine clearance of at least 60 ml/min. Dosing should begin at 50 mg three times a day (150 mg/day). The dose may be increased to 300 mg/day within 1 week based on efficacy and tolerability. Begin dosing of Pregabalin CR capsule at 165 mg once daily and increase to 330 mg once daily within 1 week based on individual patient response and tolerability. The maximum recommended dose of Pregabalin CR capsule is 330 mg once daily.
Postherpetic neuralgia in adults (PHN): The recommended dose of Pregabalin is 75 to 150 mg two times a day or 50 to 100 mg three times a day (150 to 300 mg/day) in patients with creatinine clearance of at least 60 ml/min. Dosing should begin at 75 mg two times a day or 50 mg three times a day (150 mg/day). The dose may be increased to 300 mg/day within 1 week based on efficacy and tolerability. Patients who do not experience sufficient pain relief following 2 to 4 weeks of treatment with 300 mg/day and who are able to tolerate Pregabalin, may be treated with up to 300 mg two times a day or 200 mg three times a day (600 mg/day).
Begin dosing of Pregabalin CR capsule at 165 mg once daily and increase to 330 mg once daily within 1 week based on individual patient response and tolerability. Patients who do not experience sufficient pain relief following 2 to 4 weeks of treatment with 330 mg once daily and who are able to tolerate Pregabalin CR capsule, may be treated with up to 660 mg once daily. In view of the dose-dependent adverse reactions and the higher rate of treatment discontinuation due to adverse reactions, dosing above 330 mg/day should be reserved only for those patients who have on-going pain and are tolerating 330 mg daily. The maximum recommended dose of Pregabalin CR capsule is 660 mg once daily.
Management of fibromyalgia in adults: The recommended dose of Pregabalin is 300 to 450 mg/day. Dosing should begin at 75 mg two times a day (150 mg/day). The dose may be increased to 150 mg two times a day (300 mg/day) within 1 week based on efficacy and tolerability. Patients who do not experience sufficient benefit with 300 mg/day may be further increased to 225 mg two times a day (450 mg/day).
Neuropathic pain associated with spinal cord injury in adults: The recommended dose range of Pregabalin is 150 to 600 mg/day. The recommended starting dose is 75 mg two times a day (150 mg/day). The dose may be increased to 150 mg two times a day (300 mg/day) within 1 week based on efficacy and tolerability. Patients who do not experience sufficient pain relief after 2 to 3 weeks of treatment with 150 mg two times a day and who tolerate Pregabalin may be treated with up to 300 mg two times a day.
Conversion from Pregabalin capsules to Pregabalin CR capsule tablet: When switching from Pregabalin capsules to Pregabalin CR capsule tablet on the day of the switch, instruct patients to take their morning dose of Pregabalin capsule as prescribed and initiate Pregabalin CR capsule therapy after an evening meal.
Pregabalin tablet total daily dose (dosed 2 or 3 times daily): Pregabalin CR capsule capsule dose (dosed once a day)
- 75 mg/daily: 82.5 mg/day
- 150 mg/daily: 165 mg/day
- 225 mg/daily: 247.5 mg/day
- 300 mg/daily: 330 mg/day
- 450 mg/daily: 495 mg/day
- 600 mg/daily: 660 mg/day
Administration
Route of administration: Pregabalin is taken in oral route. It can be taken with or without food. Pregabalin CR tablet should be administered after an evening meal. It should be swallowed whole and should not be split, crushed or chewed. If patients miss taking their dose of Pregabalin CR after an evening meal, then they should take their usual dose of Pregabalin CR prior to bedtime following a snack. If they miss taking the dose of Pregabalin CR prior to bedtime, then they should take their usual dose of Pregabalin CR following a morning meal. If they miss taking the dose of Pregabalin CR following the morning meal, then they should take their usual dose of Pregabalin CR at the usual time that evening following an evening meal. When discontinuing both Pregabalin and Pregabalin CR, it should be gradually tapered over a minimum of 1 week.
* চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন‘
Interaction
Drug interaction with medication: Pegamax is unlikely to be involved in significant pharmacokinetic drug interactions.
Drug interaction with food and others: Not applicable.
Contraindications
Pregabalin is contraindicated in patients with known hypersensitivity to Pregabalin or any of its components.
Side Effects
Most common side effects in adults are dizziness, somnolence, dry mouth, edema, blurred vision, weight gain and thinking abnormal (primarily difficulty with concentration/attention). Most common side effects in pediatric patients for the treatment of partial onset seizures are increased weight and increased appetite.
Pregnancy & Lactation
There are no adequate and well-controlled studies with pregabalin in pregnant women. Pregnant women should be advised of the potential risk to a fetus. Small amounts of pregabalin have been detected in the milk of lactating women. Because of the potential risk of tumorigenicity, breastfeeding is not recommended during treatment with pregabalin.
Precautions & Warnings
Angioedema (e.g., swelling of the throat, head and neck) can occur and may be associated with life threatening respiratory compromise requiring emergency treatment. Pegamax should be discontinued immediately in these cases. Pegamax should also be discontinued immediately if hypersensitivity reactions (e.g., hives, dyspnea and wheezing) occur. Antiepileptic drugs, including Pegamax, increase the risk of suicidal thoughts or behavior. Respiratory depression may occur with Pegamax when used with concomitant CNS depressants or in the setting of underlying respiratory impairment. Patients need to be monitored and dosage adjusted as appropriate. Pegamax may cause dizziness and somnolence and impair patients ability to drive or operate machinery. Increased seizure frequency or other adverse reactions may occur if Pegamax is rapidly discontinued. Pegamax should be withdrawn gradually over a minimum of 1 week. Pegamax may cause peripheral edema. Caution should be exercised when coadministering Pegamax and thiazolidinedione antidiabetic agents.
Use in Special Populations
Use in children and adolescents: Safety and effectiveness in pediatric patients have not been established for the management of neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, neuropathic pain associated with spinal cord injury and fibromyalgia. In case of adjunctive therapy for partial onset seizures, safety and effectiveness in pediatric patients below the age of 1 month have not been established. The safety and effectiveness of Pegamax extended-release tablet in pediatric patients have not been established.
Overdose Effects
In case of overdose with Pegamax, sign and symptoms are reduced consciousness, depression/anxiety, confusional state, agitation and restlessness. Seizures and heart block have also been reported. There is no specific antidote. If indicated, elimination of unabsorbed drug may be attempted by emesis or gastric lavage; usual precautions should be observed to maintain the airway. General supportive care of the patient is indicated including monitoring of vital signs and observation of the clinical status of the patient.
Therapeutic Class
Adjunct anti-epileptic drugs, Primary anti-epileptic drugs
Storage Conditions
Keep in a cool & dry place (below 30°C), protected from light & moisture. Keep out of the reach of children.
Chemical Structure
| Molecular Formula : | C8H17NO2 |
| Chemical Structure : |  |
Common Questions about Pegamax 50 mg Capsule
What is Pegamax 50 mg Capsule?
Pegamax 50 mg Capsule is an anticonvulsant and is considered to be the first-line of treatment for neurotic pain, shingles, seizures and fibromyalgia.
How long do I need to use Pegamax 50 mg Capsule before I see improvement in my condition?
Pegamax 50 mg Capsule is to be taken till the time you see an improvement in your health conditions.
At what frequency do I need to use Pegamax 50 mg Capsule?
Pegamax 50 mg Capsule should be taken in the dosage as prescribed by the doctor.
Should I use Pegamax 50 mg Capsule empty stomach, before food or after food?
Pegamax 50 mg Capsule should be taken after food in a prescribed dosage.
What are the instructions for the storage and disposal of Pegamax 50 mg Capsule?
Pegamax 50 mg Capsule should be kept in a cool dry place and in its original packaging. Make sure this medication remains unreachable to children and pets.
Does Pegamax 50 mg Capsule work in the same way for each disease?
No, Pegamax 50 mg Capsule works in different ways for different diseases.
How long do I need to take Pegamax 50 mg Capsule?
The duration of Pegamax 50 mg Capsule depends on the condition for which you are consuming this medicine. It is advised to consult the doctor before consuming Pegamax 50 mg Capsule.
Is it necessary to continue taking Pegamax 50 mg Capsule even if I feel fine?
Yes, you should not stop taking Pegamax 50 mg Capsule even if you feel fine. Consult your doctor before stopping Pegamax 50 mg Capsule.
Can I take Diazepam and Pegamax 50 mg Capsule together?
Yes, Pegamax 50 mg Capsule and Diazepam can be used together.
Can the use of Pegamax 50 mg Capsule cause weight gain?
Yes, Pegamax 50 mg Capsule may cause weight gain because it increases your hunger. Consult a dietician if you have any further concerns to keep your weight stable.
Quick Tips
- Pegamax 50 mg Capsule should be taken as per the dose and duration prescribed by your doctor.
- Pegamax 50 mg Capsule may cause sleepiness. Do not drive or do anything requiring concentration until you know how it affects you.
- Pegamax 50 mg Capsule may cause blurring or loss of vision. Inform your doctor immediately if you notice any vision changes.
- Inform your doctor if you develop any unusual changes in mood or behavior, new or worsening depression, or suicidal thoughts or behavior.
- Do not stop taking Pegamax 50 mg Capsule suddenly without talking to your doctor as it may worsen your underlying condition.
