Pregabalin Practice Review for GPs – Revisiting pregabalin: Optimising safety in prescribing for neuropathic pain

NPS MedicineWise will be sending out a PBS Practice Review report “Revisiting pregabalin: Optimising safety in prescribing for neuropathic pain”, to over 30,000 GPs across Australia next week with individualised data on their pregabalin prescribing.

This PBS Practice Review will highlight to GPs national and international concerns around increasing deaths with pregabalin, and safety concerns of the Therapeutic Goods Administration around pregabalin and gabapentin that resulted in the addition of boxed warnings to the Product Information and Consumer Medicine Information for these medicines.

The warnings added for pregabalin highlight the risk of misuse, abuse and dependence, which can lead to overdose and death, especially when combined with other central nervous system depressants. GPs are also directed to assess patient risk of misuse, abuse or dependence before prescribing pregabalin, and to monitor patients regularly during treatment.

The inclusion of individualised PBS data aims to prompt GPs to reflect on their own prescribing patterns, including prescribing of pregabalin to patients that also use opioids and/or benzodiazepines and those also prescribed pregabalin by others.

Recognising that pregabalin may be an appropriate choice for some patients, GPs are reminded not to prescribe pregabalin before making a probable neuropathic pain diagnosis, how to optimise chances of success in a therapeutic trial, and to only continue use where the benefits outweigh the harms and how to taper the medicine safely.

NPS MedicineWise CEO, Adj A/Prof Steve Morris says this Practice Review provides an opportunity for GPs to reflect on their prescribing of pregabalin and on the diagnosis and management of their patients with neuropathic pain.

“The practice review is one way NPS MedicineWise is continuing to support the best practice use of medicines and tests,” he says.

This Practice Review is an approved RACGP CPD activity. It encourages GPs to reflect on how they can optimise use of pregabalin and minimise risks of misuse and high risk combinations, in response to insights provided from their own prescribing data. Recently updated recommendations from Therapeutic Guidelines are also provided to assist reflection.

NPS MedicineWise has updated information on its website about neuropathic pain and treatment options. This includes a sample of the PBS Practice Review Revisiting pregabalin: Optimising safety in prescribing for neuropathic pain that GPs will receive in mid March 2021, videos to help with diagnosing neuropathic pain, further information about safety concerns and risks associated with pregabalin and gabapentin, and information for consumers.