Gabapentin and Pregabalin

Question 1

What are indications for the use of gabapentin and pregabalin?

Answer 1

• Focal epilepsies
• Neuropathic pain
• Gabapentin - migraine prophylaxis
• Pregabalin - Generalised anxiety disorder

Question 2

What is the mechanism of action of gabapentin and pregabalin?

Answer 2

Closely related to GABA - MOA not fully understood. It binds to Ca2+ channels, where it is thought to prevent inflow of Ca2+, resulting in inhibition of neurotransmitter release -> reduces neuronal excitability. Pregabalin hasa similar mechanism of action

Inhibit calcium cuurents via high activates calcium channels containing the alpha2delta1-subunit

Question 3

What are important adverse side effects of gabapentin and pregabalin?

Answer 3

• Drowsiness
• Dizziness
• Ataxia

Question 4

How are gabapentin and pregabalin excreted?

Answer 4

By the kidneys

Question 5

What are important interactions to be aware of when using pregabalin andd gabapentin?

Answer 5

Sedating drugs - benzos

Question 6

What would you communicate with to individuals when prescribing gabapentin/pregabalin?

Answer 6

• Start low and then incrase gradually
• Avoid driving until confident side effects have settled

Question 7

What test can result in a false positive when using gabapentin?

Answer 7

Urine dipstick - positive for protein