NPSFriday 05 April 2013, 4:56PM

Media release from NPS

The latest edition of NPS RADAR reviews pregabalin (Lyrica), a
treatment option recently listed on the PBS for people with
neuropathic pain which has not been controlled by other
drugs.

According to the independent review by NPS MedicineWise, pregabalin
appears to have similar efficacy and similar range of benefits and
harms compared to other adjuvant or add-on analgesics for
neuropathic pain.

However some uncertainty around its efficacy still exists as there
have been no head-to-head trials to test it against other drugs for
neuropathic pain.

The NPS RADAR review encourages prescribers to consider initial
treatment with another analgesic agent, such as a tricyclic
antidepressant, before pregabalin, as pregabalin is only PBS listed
as an alternative or an adjunct treatment for people with
neuropathic pain which has not been satisfactorily controlled using
other drugs.

Prescribers should also inform patients of possible side effects
and discuss realistic treatment outcomes.

Dizziness and drowsiness are common dose-dependent adverse events,
and in trials, these were the most common issues causing people to
stop pregabalin.
Patients should also be aware that it may take several weeks to
achieve maximal effect with pregabalin and if the drug needs to be
discontinued, it should be tapered off rather than abruptly
stopped, in order to avoid adverse withdrawal effects.

When prescribing pregabalin in people with impaired renal (kidney)
function, the dose should be reduced since the drug is renally
excreted.

PBAC has recommended that the drug utilisation subcommittee (DUSC)
review the usage of pregabalin 12 months after its PBS
listing.

This edition of NPS RADAR also includes full reviews for 
imiquimod cream (Aldara) for superficial basal cell carcinoma, and
sitagliptin with simvastatin (Juvicor), a fixed dose combination
medicine for treating type 2 diabetes and high cholesterol. It also
includes In Brief articles on the following medicines and PBS
listing changes:
•    Femme-Tab ED 20/100: low-dose-oestrogen
combined oral contraceptive
•    Strontium ranelate (Protos) – PBS listing
extended to include men with osteoporosis
•    Zoledronic acid (Aclasta) – PBS listing changed
to include an extended bone mineral density T-score cut-off
•    Durotram (tramadol, extended release) – PBS
listing deleted.

To read the full reviews go to www.nps.org.au/radar.

NPS RADAR is a timely, independent publication for health
professionals published by NPS MedicineWise. It provides health
professionals with evidence-based information about new drugs,
medical tests, and changes to listings on the PBS.

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