Neuropathic Pain - Drug Treatment

Gabapentin & Pregabalin

Here at Thursby Surgery we have a duty of care to all our patients to ensure safe prescribing of medication.

We continually review medication and ensure we are following guidelines and protocols both inside the practice and outside.

We are currently running a huge piece of work on Gabapentinoids.

We will be contacting you to arrange your bloods and reviews when they are due to support the above. We advise that you attend these appointments to ensure us to be able to support in managing your pain, health and wellbeing.

Please fill out the pain scoring prior to each appointment to support the consultations - click here for the document

Please note that completing the pain score does not automatically mean you will receive this medication - it might indicate an onward referral or an alternative medication

• They both belong to the same class of medicine (Gabapentinoids) and work similarly.
• Common side effects include dizziness, drowsiness, and fluid buildup.
• Pregabalin is more likely to lead to weight gain.
• Both are effective for treating nerve pain, but the choice depends on factors like severity, individual response, side effects, and cost.

Gabapentin (Neurontin) is indicated as monotherapy or adjunctive therapy for partial seizures with and without secondary generalisation. It is also indicated for peripheral neuropathic pain such as painful diabetic neuropathy and post-herpetic neuralgia (see NHS website guidance for patients)

Pregabalin (Lyrica) is indicated as adjunctive therapy for partial seizures with or without secondary generalisation. It is also indicated for peripheral and central neuropathic pain and for generalised anxiety disorder (see NHS website guidance for patients).

Gabapentinoids are eliminated from the body solely by the kidney, and pharmacokinetic studies show a stepwise prolongation in the elimination half-life of gabapentin and pregabalin as kidney function declines. Gabapentinoids should therefore be started at lower doses in patients with chronic kidney disease. Six monthly renal function blood text will need to be done along with regular medication reviews in view to potentially reduce/stop this class of medication.