The medicine "Lyric" (tablets), the price of which is from 700 to 4000 rubles, is a well-known drug. The active substance is pregabalin, an analogue of gamma-aminobutyric (gamma-aminobutyric) acid (GABA). Further in the article, an annotation to the medication will be given. We will find out why patients use Lyric tablets.
Mechanism of action
Pregabalin is effective in the treatment of diabetic neuropathy and postherpetic neuralgia, for which Lyric tablets are prescribed for up to 13 weeks with a daily intake of 2 times and a course of up to 8 weeks with 3 times a day. Against the background of the use of the drug, the same development of side effects is noted. A clearly visible reduction in pain symptoms associated with fibromyalgia is noted when taking the drug in doses of 300-600 mg per day. Daily dosages of 450 mg and 600 mg can be compared by effectiveness, but the latter is worse tolerated. The medicine reduces the severity of epileptic seizures, for which Lyric tablets are recommended for a course of 12 weeks 2 or 3 times a day. In the process of taking the same picture of the development of side effects and the effectiveness of the drug at this dosage. The frequency of seizures begins to decrease already in the first week of taking the medicine. Symptoms of generalized anxiety disorder show a tendency to decrease already in the first seven days of treatment. After an eight-week use of the drug, 52% of patients who received pregabalin and 38% of patients who took placebo showed a 50% reduction in symptoms on the Hamilton scale (NAM-A).
Pharmacokinetics
Medication "Lyric" (tablets) - the instruction confirms this - in the recommended daily doses from the pharmacokinetic side it is characterized by linearity, low (<20%) interindividual variability. With repeated use, the pharmacokinetics of the drug can be predicted based on data from a single dose. Therefore, it is not necessary to regularly monitor the concentration of the active component. Pharmacokinetic parameters of the drug "Lyric" in healthy volunteers, epileptic patients who receive antiepileptic therapy, and also receiving a drug to suppress pain syndromes, are similar.
Suction and removal
After taking on an empty stomach, pregabalin is absorbed very quickly. After one hour, Cmax in plasma is achieved both when applied for the first time, and when repeated. Against the background of oral administration, the bioavailability of pregabalin is at a level of ≥90% and does not depend on the dose. Equilibrium with repeated administration is achieved in a period of 24-48 hours. If the drug is used after a meal, then Cmax may decrease by 25-30%, and its achievement will increase in time to 2.5 hours. But meals have no clinically significant effect on the absorption of the drug. Basically, the medicine is excreted by the kidneys unchanged. T1 / 2 averages 6.3 hours.
Pharmacokinetics in special cases
If renal function is impaired, it is necessary to take into account the peculiarity of pregabalin clearance that it is directly proportional to creatinine clearance. Basically, the drug is excreted by the kidneys, so it is necessary to reduce the dose if their function is impaired. In addition to the kidneys, the medication can be effectively removed from plasma by hemodialysis (a 4-hour hemodialysis session reduces the concentration of the drug in plasma by 50%), after which an additional dose of the drug is recommended. A special study of the pharmacokinetics of Lyric in patients with impaired liver function has not been conducted.
Pregabalin is practically not subject to metabolism; it is excreted unchanged with urine, therefore, impaired liver function will not significantly affect the concentration of the drug in plasma. When the drug is prescribed to patients older than 65 years of age, it must be taken into account that with age, pregabalin clearance tends to decrease. If an elderly person has impaired renal function, a reduction in the prescribed dose of the drug is necessary.
Dosage
The daily amount of the drug is estimated at 150-600 mg per day. Reception is carried out twice or thrice, regardless of food. Medication "Lyric" (tablets); instructions for use recommends taking with neuropathic pain 150 mg per day. If the achieved effect and tolerance are positive, after a week the daily dose can be increased to 300 mg (Lyric 300 tablets are prescribed). If necessary, the maximum dose of 600 mg per day can be prescribed another week later. Similarly, the doses of the drug are calculated in the treatment of epilepsy. As mentioned above, the drug is recommended in the treatment of fibromyalgia, for which Lyric tablets are prescribed in a dose of 75 mg in two doses per day. The increase in dose to 300 mg is affected by the achieved effect and tolerance. If there is no positive effect, the dose is increased to 450 mg, and if necessary, after a week to 600 mg. Generalized anxiety disorder is treated with a dose of 150 mg. Also, after a week, observing the achieved effect and tolerance, the daily dose is increased to 450 mg, and after another 7 days to 600 mg (if necessary).
Drug withdrawal
If it is necessary to stop treatment, it is recommended to do this for at least a week during a gradual dose reduction. Patients with impaired renal function, an individual selection of doses. In case of undesirable consequences on the background of taking Lyric, analog tablets are selected by a specialist. Among the most common drugs with a similar effect should be called drugs "Midokalm", "Apizartron", "Sedavit", "Ambene".
Indications
The medication is recommended for eliminating neuropathic pain, as an additional therapy for partial convulsive attacks of epilepsy, which are accompanied or not accompanied by secondary generalization. The remedy is indicated for anxiety disorder of a generalized nature, as well as for fibromyalgia.
Contraindications
There is no data on the use of the drug in children and adolescents under 17 years old inclusive. In this regard, the medication is prescribed only for adults. Contraindications include hereditary diseases in the form of galactose intolerance, lactase deficiency, as well as impaired glucose / galactose absorption. The drug is not prescribed for hypersensitivity. Careful prescribing of the drug to patients with renal and heart failure is necessary.
Side effects
According to the experience of the clinical use of the medication, dizziness and drowsiness are noted as undesirable consequences. These phenomena, as a rule, manifest themselves in a moderate or mild degree. Among other side effects that led to the cessation of treatment with the drug, it should be noted asthenia, confusion, blurred vision, impaired coordination, ataxia, peripheral edema.
Among the negative consequences, headache, loss of consciousness, cramps, swelling of the tongue, diarrhea, nausea, keratitis are noted. Itchy skin and angioedema rarely occur. Urinary retention, pulmonary edema, and gynecomastia are possible. Among other side effects called increased fatigue.