Lyrics - instructions for use, reviews, analogs and formulations (capsules or tablets 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg and 300 mg) drugs for the treatment of epilepsy in adults, children and pregnancy. Composition and interaction with alcohol

In this article, you can read the instructions for using the drug Lyrics. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Lyrics in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Lyrical Analogues in the presence of existing structural analogs. Use for the treatment of epilepsy and neuropathic pain in adults, children, as well as during pregnancy and lactation.Composition and interaction of the drug with alcohol.

Lyrics - antiepileptic drug, the active substance of which is an analogue of gamma-aminobutyric (gamma-aminobutyric acid) (GABA).

It was established that pregabalin (the active substance of the Lyrical preparation) binds to the additional subunit (alpha2-delta protein) of the potential-dependent calcium channels in the CNS, irreversibly replacing [3H] -gabapentin. It is suggested that such binding can contribute to the manifestation of its analgesic and anticonvulsant effects.

Neuropathic pain

The efficacy of pregabalin was noted in patients with diabetic neuropathy and postherpetic neuralgia.

It has been established that when taking pregabalinum with courses up to 13 weeks 2 times a day and up to 8 weeks 3 times a day, in general, the risk of side effects and the effectiveness of the drug at 2 or 3 times a day are the same.

When taking a course of up to 13 weeks, the pain decreased during the first week, and the effect persisted until the end of treatment.

A 50% reduction in pain index was noted in 35% of patients treated with pregabalin and 18% in patients taking placebo.Among patients who did not experience drowsiness, the effect of this pain reduction was observed in 33% of patients in the pregabalin group and 18% in the placebo group. 48% of patients taking pregabalin and 16% of patients receiving placebo had drowsiness.

Fibromyalgia

A marked decrease in pain symptoms associated with fibromyalgia is noted with the use of pregabalin in doses from 300 mg to 600 mg per day. The efficacy of doses of 450 mg and 600 mg per day is comparable, but tolerability of 600 mg per day is usually worse. Also, the use of pregabalin is associated with a marked improvement in the functional activity of patients and a decrease in the severity of sleep disorders. The use of pregabalin at a dose of 600 mg per day led to a more pronounced improvement in sleep, compared with a dose of 300-450 mg per day.

Epilepsy

When taking the drug for 12 weeks 2 or 3 times a day, the noted risk of side effects and the effectiveness of the drug under these dosing regimens are the same. The reduction in the frequency of seizures began within the first week.

Generalized anxiety disorder

Reduction of symptoms of generalized anxiety disorder is noted in the first week of treatment.When the drug was used for 8 weeks, 52% of patients receiving pregabalin and 38% of patients receiving placebo had a 50% reduction in the Hamilton anxiety symptom score (NAM-A).

Composition

Pregabalin + excipients.

Pharmacokinetics

The pharmacokinetics of pregabalin in the range of recommended daily doses is linear, interindividual variability is low (less than 20%). The pharmacokinetics of the drug in repeated application can be predicted on the basis of single dose data. Consequently, there is no need for regular monitoring of pregabalin concentrations. Parameters of pharmacokinetics of pregabalin in equilibrium in healthy volunteers, in patients with epilepsy receiving antiepileptic therapy, and in patients receiving it for chronic pain syndromes were similar.

Pregabalin is rapidly absorbed after ingestion on an empty stomach. Bioavailability of pregabalinum at intake makes more than 90% and does not depend on a dose. With repeated application, the equilibrium state is reached after 24-48 hours. The intake of food does not have a clinically significant effect on the total absorption of pregabalin.The drug does not bind to plasma proteins.

Pregabalinum is practically not exposed to a metabolism. After taking labeled pregabalin, approximately 98% of the radioactive label was detected in the urine unchanged. The proportion of the N-methylated derivative of pregabalin, which is the main metabolite found in the urine, was 0.9% of the dose.

Pregabalin is excreted mainly by the kidneys in unchanged form.

The sex of the patient does not have a clinically significant effect on the concentration of pregabalin in plasma.

When prescribing the drug, patients older than 65 years should take into account that the clearance of pregabalin with age tends to decrease, which reflects the age-related decrease in QC. Elderly people with impaired renal function may need to reduce the dose of the drug.

Indications

Neuropathic pain

• treatment of neuropathic pain in adults.

Epilepsy

• as an additional therapy in adults with partial seizures, accompanied or not accompanied by secondary generalization.

Generalized anxiety disorder

• treatment of generalized anxiety disorder in adults.

Fibromyalgia

• treatment of fibromyalgia in adults.

Forms of release

Capsules 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg and 300 mg (sometimes mistakenly referred to as tablets).

Instructions for use and dosage

The drug is taken orally regardless of food intake in a daily dose of 150 to 600 mg in 2 or 3 divided doses.

With neuropathic pain, treatment starts with a dose of 150 mg per day. Depending on the effect achieved and tolerance in 3-7 days, the dose can be increased to 300 mg per day, and, if necessary, after 7 days - up to a maximum dose of 600 mg per day.

With epilepsy, treatment starts with a dose of 150 mg per day. Taking into account the achieved effect and tolerability after 1 week, the dose can be increased to 300 mg per day, and in a week to a maximum dose of 600 mg per day.

With fibromyalgia, treatment starts with a dose of 75 mg twice a day (150 mg per day). Depending on the effect achieved and the tolerability after 3-7 days, the dose can be increased to 300 mg per day. In the absence of a positive effect, the dose is increased to 450 mg per day, and if necessary, after 7 days - up to a maximum dose of 600 mg per day.

With a generalized anxiety disorder, treatment starts with a dose of 150 mg per day. Depending on the effect achieved and the tolerability after 7 days, the dose can be increased to 300 mg per day.In the absence of a positive effect, the dose is increased to 450 mg per day, and if necessary, after 7 days - up to a maximum dose of 600 mg per day.

Canceling the drug Lyrics: if treatment should be stopped, then it is recommended to do this gradually for at least 1 week.

In patients with impaired liver function, dose adjustment is not required.

Patients older than 65 years may need to reduce the dose of pregabalin due to a decrease in kidney function.

In the case of missing a dose of pregabalin, the next dose should be taken as soon as possible, however, do not take the missed dose if the next time is appropriate.

Side effect

• nasopharyngitis;
• neutropenia;
• increased appetite;
• increase in body weight;
• anorexia;
• hypoglycemia;
• decrease in body weight;
• euphoria;
• confusion of consciousness;
• decreased libido;
• irritability;
• insomnia;
• disorientation;
• depersonalization;
• anorgasmia;
• anxiety;
• depression;
• depressed mood;
• difficulties in the selection of words;
• hallucinations;
• unusual dreams;
• increased libido;
• panic attacks;
• apathy;
• increased insomnia;
• disinhibition;
• a good mood;
• dizziness;
• drowsiness;
• violation of attention;
• lack of coordination;
• memory impairment;
• tremor;
• amnesia;
• speech impairment;
• weakening of reflexes;
• psychomotor agitation;
• loss of taste;
• fainting;
• blurred vision;
• narrowing of the fields of vision;
• decreased visual acuity;
• pain in the eyes, asthenopia;
• dryness in the eyes;
• swelling of the eyes;
• increased lacrimation;
• loss of peripheral vision;
• strabismus;
• increased brightness of visual perception;
• dizziness;
• hyperacusis;
• tachycardia;
• AV-blockade of 1 degree;
• tides;
• a decrease in blood pressure;
• coldness of limbs;
• increased blood pressure;
• sinus tachycardia;
• sinus arrhythmia;
• sinus bradycardia;
• dyspnea;
• cough;
• dryness of the nasal mucosa;
• nasal congestion;
• bleeding from the nose;
• dry mouth;
• constipation;
• vomiting;
• flatulence;
• bloating;
• pancreatitis;
• hyperemia of the skin;
• sweating;
• papular rash;
• hives;
• swelling of the joints;
• muscle spasms;
• myalgia;
• arthralgia;
• backache;
• pain in the limbs;
• stiffness in the muscles;
• rhabdomyolysis;
• urinary incontinence;
• kidney failure;
• erectile disfunction;
• delay in ejaculation;
• sexual dysfunction;
• pain in the mammary glands;
• discharge from the mammary glands;
• increase of mammary glands in volume;
• a decrease in the number of platelets;
• increase in glucose and creatinine in the blood;
• decrease in the level of potassium in the blood;
• a decrease in the number of leukocytes in the blood;
• fatigue;
• peripheral edema;
• feeling of intoxication;
• violation of gait;
• thirst;
• chills;
• hyperthermia.

Contraindications

• children and adolescents under 17 years of age (no application data);
• rare hereditary diseases, incl. intolerance to galactose, lactase deficiency and impaired absorption of glucose / galactose;
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

There is no adequate data on the use of pregabalin in pregnancy.

In experimental animal studies, the drug had a toxic effect on reproductive function.

In connection with this, the Lyrical preparation can be prescribed during pregnancy only if the intended benefit for the mother clearly outweighs the possible risk to the fetus.

When using the Lyrics, women of reproductive age should use adequate methods of contraception.

There is no information about the excretion of pregabalin with breast milk in women. However, in experimental studies it has been established that it is excreted in breast milk in rats. In this regard, during treatment with the Lyrical preparation, it is recommended to stop breastfeeding.

Application in elderly patients

Older patients (over 65 years of age) may need to reduce the dose of pregabalin due to a decrease in kidney function.

Use in children

Contraindicated in children and adolescents under the age of 17 years (no application data).

special instructions

Part of patients with diabetes mellitus in case of weight gain on the background of treatment with pregabalin may require correction of doses of hypoglycemic drugs.

Pregabalinum should be canceled in case of development of symptoms of angioneurotic edema (such as, facial edema, perioral edema or swelling of the tissues of the upper respiratory tract).

Antiepileptic drugs, including Lyric, may increase the risk of suicidal thoughts or behavior. Therefore, patients receiving these drugs should be carefully monitored for the appearance or deterioration of depression, the appearance of suicidal thoughts or behavior.

Treatment with pregabalin was accompanied by dizziness and drowsiness, which increases the risk of accidental injuries (falls) in the elderly. During the postmarketing use of the drug, there were also cases of loss of consciousness, confusion, and cognitive impairment. Therefore, until patients do not evaluate the possible effects of the drug, they must be careful.

Information on the possibility of canceling other anticonvulsants with suppression of seizures with pregabalin and the advisability of monotherapy with this drug are insufficient. There are reports of the development of seizures, including. epileptic status and small seizures on the background of the use of pregabalin or immediately after the termination of therapy.

If such undesirable reactions as blurred vision or other disturbances on the part of the visual organ appear during treatment with pregabalin, the withdrawal of the drug may lead to the disappearance of these symptoms.

There were also cases of development of renal failure, in some cases after the abolition of pregabalin kidney function was restored.

As a result of abortion of the Lyrics after long or short-term therapy, the following undesirable effects were observed: insomnia,headache, nausea, diarrhea, flu-like syndrome, depression, sweating, dizziness, convulsions and anxiety. Information on the incidence and severity of manifestations of the syndrome of cancellation of pregabalin, depending on the duration of therapy, and its dose is not available.

During the post-marketing application of the drug, chronic heart failure was reported against the background of pregabalin therapy in some patients. These reactions were predominantly observed in elderly patients who had cardiac dysfunction and received a drug for neuropathy. Therefore, pregabalin should be used with caution in this category of patients. After the abolition of pregabalin, the disappearance of manifestations of such reactions is possible.

The incidence of adverse events on the part of the CNS, especially such as drowsiness, increases with the treatment of central neuropathic pain due to spinal cord injury, which may however be the result of the summation of the effects of pregabalin and other concurrent agents (eg, antispastic). This circumstance should be taken into account when presgabalin is prescribed for this indication.

There are reports of cases of development of dependence when using pregabalin. Patients with drug dependence in a history need careful medical observation for symptoms of dependence on pregabalin.

There have been cases of encephalopathy, especially in patients with concomitant diseases, which can lead to the development of encephalopathy.

Impact on the ability to drive vehicles and manage mechanisms

Lyrics can cause dizziness and drowsiness and accordingly affect the ability to drive vehicles and use sophisticated technology. Patients should not drive vehicles, use complex equipment or perform other potentially dangerous activities until an individual response to the drug is established.

Drug Interactions

Lyrics are excreted in the urine mostly unchanged, subject to minimal metabolism in humans (in the form of metabolites with urine output is less than 2% of the dose), does not inhibit the metabolism of other drugs and does not bind to plasma proteins, so it is unlikely to enter into a pharmacokinetic interaction .

There were no signs of clinically significant pharmacokinetic interaction of pregabalin with phenytoin, carbamazepine, valproic acid, lamotrigine, gabapentin, lorazepam, oxycodone and ethanol (alcohol). It has been established that oral hypoglycemic drugs, diuretics, insulin, phenobarbital, tiagabine and topiramate have no clinically significant effect on the clearance of pregabalin.

With the use of oral contraceptives containing norethisterone and / or ethinyl estradiol, the equilibrium pharmacokinetics of both drugs did not change simultaneously with pregabalin.

There were reported cases of respiratory failure and coma development with the simultaneous use of pregabalin with other drugs that depress the central nervous system.

It was also reported about the negative effect of pregabalin on gastrointestinal tract activity (including the development of intestinal obstruction, paralytic ileus, constipation) with simultaneous use with drugs that cause constipation (such as non-narcotic analgesics).

Repeated oral administration of lyric with oxycodone, lorazepam or ethanol did not have a clinically significant effect on respiration.Pregabalin, apparently, enhances cognitive and motor function disorders caused by oxycodone. Pregabalin can enhance the effects of ethanol (alcohol) and lorazepam.

Analogues of the medicinal product Lyrics

Structural analogs for the active substance:

• Algerian;
• Pregabalin;
• Pregabalin Richter.

Analogues on the curative effect (antiepileptic drugs):

• Actinerval;
• Algerian;
• Benzobarbital;
• Benzon;
• Valparin;
• Gabagamma;
• Gapentec;
• Depakin;
• Depakin chrono;
• Diazepam;
• Diakarb;
• Diphenine;
• Carbamazepine;
• Clonazepam;
• Convulsant;
• Lamitor;
• Lamotrigine;
• Levetiracetam;
• Neuronthin;
• Pregabalin;
• Relium;
• Rivotril;
• Sibazon;
• Tegretol;
• Topamax;
• Phenobarbital;
• Finlepsin;
• Finlepsin retard;
• Chloracon;
• Enkorat;
• Epimax;
• Epitera.

Similar medicines:

Other medicines: