Tuesday May 15, 2018
Pregabalin was fully subsidised from 1 May 2018. Gabapentin and Pregabalin are currently prescribed for the management of neuropathic pain.
Current evidence suggests Pregabalin poses a significantly increased risk of abuse and overdose in people with a concurrent substance use disorder (SUD). The risk of misuse of gabapentinoids (Gabapentin and Pregabalin) in a general population is estimated to be 1.6% but this rises significantly in people with a history of opioid misuse.
Gabapentinoids can increase the effect of opioids and recreational drugs, increasing the risk of adverse effects and accidental overdose. Pregabalin may have a greater potential for misuse because it has a greater bioavailability at high doses. The favourable drug profile, ease of access, availability and lack of detection means Pregabalin misuse is increasing worldwide. There is an international move towards restricting prescribing and scheduling of Pregabalin. It is about to be scheduled as a Class C controlled drug in the UK.
BOPAS would like to emphasize caution when prescribing Pregabalin and special care should be taken in populations with history of substance use disorder.