Patients with diabetes mellitus
A part of patients with diabetes mellitus in case of weight gain on the background of treatment with pregabalin may require correction of doses of hypoglycemic agents.
Hypersensitivity reactions
Pregabalinum should be canceled in case of development of symptoms of angioedema (such as facial edema, perioral edema or swelling of the tissues of the upper respiratory tract).
Suicidal thoughts and behavior
Antiepileptic drugs, including pregabalinum, may increase the risk of suicidal thoughts or behavior. Therefore, patients receiving these drugs should be carefully monitored for the appearance or deterioration of depression, the appearance of suicidal thoughts or behavior.
Decreased gastrointestinal function
With the simultaneous use of pregabalin and opioids, consideration should be given to the need for preventive measures to prevent the development of constipation (especially in elderly patients and women).
Dizziness, drowsiness, loss of consciousness, confusion and cognitive impairment
Treatment with pregabalin was accompanied by dizziness and drowsiness, which increases the risk of accidental injuries (falls) in the elderly. In the course of post-marketing use of the drug, there were also cases of loss of consciousness, confusion and violation of cognitive functions.
Therefore, as long as patients do not evaluate the possible effects of the drug, they should be careful.
Cancellation of concomitant therapy with anticonvulsants
Information on the possibility of canceling other anticonvulsants with suppression of seizures with pregabalin and the advisability of monotherapy with this drug are insufficient. There are reports of the development of seizures, including epileptic status and minor seizures with pregabalin or immediately after therapy.
Effect of pregabalin on vision
In clinical studies in patients who were continuously receiving β-pregabalin, a side effect such as blurred vision was more common than in patients receiving placebo. At the same time, this side effect ceased as the treatment continued. In clinical studies, during which an ophthalmologic examination of patients was performed, visual acuity and visual field changes were more often observed in patients receiving pregabalinumthan in those receiving placebo. The frequency of changes in the fundus was higher in patients receiving a placebo.
Despite the fact that the clinical significance of these disorders is not established, patients should be informed of the changes in vision with pregabalin therapy. If symptoms persist, visual impairment should be continued. More frequent eye examinations should be performed in patients who are already regularly observed with an ophthalmologist. When such undesirable reactions appear in response to the use of pregabalin such as loss of vision, blurred vision or other abnormalities on the part of the visual organ, the withdrawal of the drug may lead to the disappearance of these symptoms.
Renal insufficiency
There were also cases of development of renal failure; in some cases, after the abolition of pregabalin, the kidney function was restored.
Symptoms of cancellation of pregabalinum
As a result of cancellation of pregabalin after prolonged or short-term therapy, the following undesirable phenomena were observed: insomnia, headache, nausea, diarrhea, flu-like syndrome, depression, sweating, dizziness, convulsions and anxiety. The available data indicate that the incidence and severity of manifestations of the "withdrawal" syndrome may depend on the dose of pregabalin.
Abuse of pregabalin
There is no evidence that pregabalinum is active against receptors responsible for the development of drug abuse in patients. During post-registration studies, cases of a violation of the recommended dosing regimen or abuse of pregabalin were noted. As with any drug that affects the central nervous system, one should carefully evaluate the patient's medical history for the cases of drug abuse, and observe the patient in connection with the possibility of a violation of the recommended dosing regimen or abusepregabalin (for example, development of resistance to pregabalin therapy, unreasonable increase in the dose of the drug, addictive behavior of the patient).
Congestive heart failure
Despite the fact that there was no obvious correlation with the pregabalin concentration in the blood plasma and the development of heart failure, during the post-marketing use of the drug, the development of chronic heart failure was reported against the background of pregabalin therapy in some patients. In patients without clinically significant signs of heart disease and blood vessels, there was no association between peripheral edema and cardiovascular complications, such as increased blood pressure or chronic heart failure. These reactions were predominantly observed in elderly patients with cardiac impairment and who received the drug for neuropathy. therefore pregabalinum this category of patients should be used with caution. After the abolition of pregabalin, the disappearance of manifestations of such reactions is possible.
Thosecentral nervous neuropathy pain relief, associated with damage to the spinal cord
The incidence of adverse events on the part of the CNS, especially such as drowsiness, is increased in the treatment of central neuropathic pain caused by spinal cord injury, which, however, may be a consequence of the summation of the effects of pregabalin and other concurrent agents (eg, antispastic). This circumstance should be taken into account when presgabalin is prescribed for this indication.
Encephalopathy
There have been cases of encephalopathy, especially in patients with concomitant diseases, which can lead to the development of this condition.