Pregabalin PBS listed as an alternative treatment for neuropathic pain

5 April 2013

The latest edition of NPS RADAR reviews pregabalin (Lyrica), a treatment option recently listed on the PBS for people with neuropathic pain which has not been controlled by other drugs.

According to the independent review by NPS MedicineWise, pregabalin appears to have similar efficacy and similar range of benefits and harms compared to other adjuvant or add-on analgesics for neuropathic pain.

However some uncertainty around its efficacy still exists as there have been no head-to-head trials to test it against other drugs for neuropathic pain.

The NPS RADAR review encourages prescribers to consider initial treatment with another analgesic agent, such as a tricyclic antidepressant, before pregabalin, as pregabalin is only PBS listed as an alternative or an adjunct treatment for people with neuropathic pain which has not been satisfactorily controlled using other drugs.

Prescribers should also inform patients of possible side effects and discuss realistic treatment outcomes.

Dizziness and drowsiness are common dose-dependent adverse events, and in trials, these were the most common issues causing people to stop pregabalin. Patients should also be aware that it may take several weeks to achieve maximal effect with pregabalin and if the drug needs to be discontinued, it should be tapered off rather than abruptly stopped, in order to avoid adverse withdrawal effects.

When prescribing pregabalin in people with impaired renal (kidney) function, the dose should be reduced since the drug is renally excreted.

PBAC has recommended that the drug utilisation subcommittee (DUSC) review the usage of pregabalin 12 months after its PBS listing.

This edition of NPS RADAR also includes full reviews for imiquimod cream (Aldara) for superficial basal cell carcinoma, and sitagliptin with simvastatin (Juvicor), a fixed dose combination medicine for treating type 2 diabetes and high cholesterol. It also includes In Brief articles on the following medicines and PBS listing changes:

  • Femme-Tab ED 20/100: low-dose-oestrogen combined oral contraceptive
  • Strontium ranelate (Protos) – PBS listing extended to include men with osteoporosis
  • Zoledronic acid (Aclasta) – PBS listing changed to include an extended bone mineral density T-score cut-off
  • Durotram (tramadol, extended release) – PBS listing deleted.

To read the full reviews go to www.nps.org.au/radar.

NPS RADAR is a timely, independent publication for health professionals published by NPS MedicineWise. It provides health professionals with evidence-based information about new drugs, medical tests, and changes to listings on the PBS.

ENDS

Independent, evidence-based and not-for-profit, NPS MedicineWise enables better decisions about medicines and medical tests. We are funded by the Australian Government Department of Health and Ageing.

Media enquiries: Stephanie Childs on 02 8217 8667, 0419 618 365 or schilds@nps.org.au