An oral drug for treating neuropathic pain from diabetic peripheral neuropathy. Pregabalin is marketed by Pfizer under the brand name Lyrica.
Diabetic peripheral neuropathy is one manifestation of diabetic neuropathy, a form of nerve damage associated with high blood glucose levels. Symptoms of diabetic neuropathy tend to appear within 10 to 20 years after a person is diagnosed with diabetes, and it affects an estimated 60% of people with diabetes of long duration to some degree. Peripheral neuropathy can produce such symptoms as numbness, tingling, and a burning or stabbing pain in the feet, legs, hands, and arms.
Diabetic neuropathy is notoriously difficult to treat. Keeping blood glucose levels close to normal can help prevent diabetic neuropathy, and avoiding wide swings in blood glucose can minimize neuropathic pain. More recently, research suggests that maintaining a healthy weight, stopping smoking, controlling high blood pressure, and keeping one’s triglyceride level in the recommended range can also help prevent neuropathy. A number of drugs can offer symptomatic relief, including antidepressants such as amitriptyline, anticonvulsant drugs such as carbamazepine (Tegretol) and gabapentin (Neurontin), narcotics, and a topical over-the-counter drug called capsaicin.
Pregabalin received marketing approval from the US Food and Drug Administration in December 2004, for managing neuropathic pain associated with diabetic peripheral neuropathy and postherpetic neuralgia (painful symptoms due to nerve damage from a herpes infection). Pregabalin works in a way similar to Pfizer’s previous anticonvulsant gabapentin, by increasing levels of a neurotransmitter (chemical messenger in nerves) called gamma-aminobutyric acid, or GABA. However, pregabalin is more potent than gabapentin, achieving the same efficacy at lower doses, which could translate into fewer side effects.
In a number of randomized, placebo-controlled, clinical trials, people with diabetic peripheral neuropathy who took pregabalin had significant reductions in pain and improved sleep. The drug was generally well tolerated. The most common side effects were dizziness and somnolence (sleepiness). If you have symptoms of diabetic neuropathy that aren’t responding adequately to the medicines or other therapies you’re using, ask your doctor whether pregabalin might be an option for you.