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Anticonvulsant / Neuropathic Analgesic

Pregabalin (Burns — Neuropathic Pain)

Brand names: Lyrica

Pregabalin is an oral gabapentinoid used in burns care as an adjuvant for neuropathic pain and to reduce the hyperalgesic, central component of burn and graft-site pain within a multimodal regimen.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds the alpha-2-delta subunit of voltage-gated calcium channels, reducing excitatory neurotransmitter release and dampening central sensitisation and neuropathic pain signalling.

Prescribing in practice

  • Combined with opioids it potentiates sedation and respiratory depression — an MHRA-warned interaction — so titrate cautiously and monitor sedation in burns patients already on strong opioids.
  • It is renally cleared and requires dose reduction in renal impairment, which is common after major burns, and it should be tapered rather than stopped abruptly to avoid withdrawal.
  • Pregabalin is a controlled drug with recognised misuse potential, so prescribe and document accordingly and review the ongoing need as pain settles.

Monitoring

Monitor neuropathic pain scores, sedation, dizziness and renal function, and review the continued need with a plan for tapering.

Counselling the patient

  • This targets the burning, shooting nerve-type pain and works alongside your other painkillers.
  • It can make you drowsy or dizzy, especially with opioids, so report excessive sleepiness.
  • Do not stop it suddenly; the team will reduce it gradually.

Evidence & guidelines

Gabapentinoids are used as neuropathic-pain adjuncts; the MHRA has warned of serious respiratory depression risk when combined with opioids.

Reference: MHRA Drug Safety Update 2019 (Pregabalin Schedule 3); BBA Pain Guidelines; NICE NG193 (Chronic Pain); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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