Pregabalin
Pregabalin is an anticonvulsant and neuropathic analgesic.
Group
Anticonvulsant and neuropathic analgesic
Mechanism of Action
Binds neuronal alpha2-delta calcium-channel subunits, reducing excitatory neurotransmission; it is not a GABA receptor agonist.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Adjunct seizure treatment — Initial | 2 mg/kg | PO | Every 8 h | Increase gradually to a tolerated 3-4 mg/kg. |
| Adjunct seizure treatment — Maintenance | 3–4 mg/kg | PO | Every 8 h | |
| Neuropathic pain | 4–5 mg/kg | PO | Every 12 h | Starting range; adjust gradually if necessary. |
| Neuropathic pain or seizure pharmacokinetic regimen | 4 mg/kg | PO | Every 12 h | Single-dose exposure study prediction, not demonstrated clinical efficacy. |
| Adjunct seizure treatment — Maintenance | 3–4 mg/kg | PO | Every 8–12 h | Start 2 mg/kg and increase by 1 mg/kg each week as tolerated. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Seizures or neuropathic pain — Initial | 2 mg/kg | PO | Every 12 h | |
| Seizures or neuropathic pain — Maintenance | 4 mg/kg | PO | Every 12 h | |
| Seizures or neuropathic pain — Initial | 1–2 mg/kg | PO | Every 12 h | Anecdotal and single-dose feline studies; titrate cautiously. |
Horses
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Reported pregabalin therapy | 4 mg/kg | PO | Every 8 h |
Indications
- Adjunct anticonvulsant treatment
- Neuropathic pain
- Neuropathic pain or seizure pharmacokinetic regimen
- Adjunct seizure treatment
- Seizures or neuropathic pain
Contraindications
- Renal elimination may require individualized treatment; reproductive safety is not established.
Interactions
- Other CNS depressants increase sedation.
Adverse effects
- Sedation and ataxia, increasing with dose.
Toxicity
Animal overdose experience is limited and no specific antidote is established. Monitor CNS depression and provide supportive care; renal elimination affects duration.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Pregabalin capsule 25 mg | Capsule | 25 mg / capsule | PO |
| Pregabalin capsule 50 mg | Capsule | 50 mg / capsule | PO |
| Pregabalin capsule 75 mg | Capsule | 75 mg / capsule | PO |
| Pregabalin capsule 100 mg | Capsule | 100 mg / capsule | PO |
| Pregabalin capsule 150 mg | Capsule | 150 mg / capsule | PO |
| Pregabalin capsule 200 mg | Capsule | 200 mg / capsule | PO |
| Pregabalin capsule 225 mg | Capsule | 225 mg / capsule | PO |
| Pregabalin capsule 300 mg | Capsule | 300 mg / capsule | PO |
| Pregabalin commercial oral solution 20 mg/mL Cited commercial solution: use within 45 days after first opening; not a compounded-liquid beyond-use date. | Oral Liquid | 20 mg / mL | PO |
Monitoring and Administration
Give with or without food; titrate gradually. Avoid abrupt withdrawal after prolonged use. Monitor sedation, gait and seizure response; compounded stability is unestablished.
The cited commercial pregabalin oral solution has a 45-day in-use period after opening; this does not establish a beyond-use date for compounded liquids.