Pregabalin
[CAS# 148553-50-8]

Identification

• Classification: API >> Nervous system medication >> Antiepileptic and anticonvulsant
• Name: Pregabalin
• Synonyms: 3-(Aminomethyl)-5-methyl-hexanoic acid
• Molecular Formula: C₈H₁₇NO₂
• Molecular Weight: 159.23
• CAS Registry Number: 148553-50-8
• EC Number: 604-639-1
• SMILES: CC(C)C[C@@H](CC(=O)O)CN

Safety Data

• Hazard Symbols: GHS02;GHS08 Danger
• Risk Statements: H318-H361-H373
• Safety Statements: P203-P260-P264+P265-P280-P305+P354+P338-P317-P318-P319-P405-P501

Hazard Classification

Hazard	Class	Category Code	Hazard Statement
Reproductive toxicity	Repr.	2	H361
Serious eye damage	Eye Dam.	1	H318
Specific target organ toxicity - repeated exposure	STOT RE	2	H373
Specific target organ toxicity - single exposure	STOT SE	3	H336
Eye irritation	Eye Irrit.	2	H319
Reproductive toxicity	Lact.	-	H362
Skin irritation	Skin Irrit.	2	H315
Acute toxicity	Acute Tox.	4	H332
Acute toxicity	Acute Tox.	3	H301
Specific target organ toxicity - single exposure	STOT SE	3	H335
Carcinogenicity	Carc.	2	H351
Acute toxicity	Acute Tox.	4	H312
Reproductive toxicity	Repr.	2	H361fd
Acute toxicity	Acute Tox.	4	H302

• Controlled Substance: DEA Drug Code Number: 2782

Discovery and Applications

Pregabalin is a drug used to treat neuropathic pain and epilepsy, developed by pharmacologist Richard Bruce Silverman and his team at Northwestern University in the 1990s. It was synthesized during research into new epilepsy treatments for calcium channels in the nervous system. Pregabalin was patented in 1996 and approved by the FDA in 2004 under the brand name Lyrica after clinical trials proved its effectiveness and safety.

Pregabalin is widely used to treat neuropathic pain, a chronic pain caused by nerve damage. Diseases such as diabetic neuropathy, postherpetic neuralgia, and spinal cord injury often cause neuropathic pain, which is characterized by burning, tingling, or electric shock sensations. Pregabalin works by modulating calcium channel activity in neurons, reducing the release of neurotransmitters involved in pain signaling, thereby effectively relieving neuropathic pain and becoming a commonly prescribed drug for patients.

Pregabalin is approved for the treatment of fibromyalgia, a disease characterized by widespread musculoskeletal pain, fatigue, and tenderness. The exact cause of fibromyalgia is unknown, but it is believed to be related to abnormal pain processing in the central nervous system. Pregabalin reduces pain and improves patients' quality of life by reducing the pain sensitivity associated with the disease. It is one of the few drugs specifically targeted for this condition, providing relief when traditional pain relievers are ineffective.

Pregabalin is used as an adjunctive therapy for partial-onset seizures in epilepsy. Seizures are caused by abnormal electrical activity in the brain, and pregabalin helps stabilize this activity by reducing excessive neuronal firing. By binding to the alpha-2-delta subunit of voltage-gated calcium channels, pregabalin reduces the release of neurotransmitters, which reduces the likelihood of seizures. It is used with other anti-seizure drugs to enhance seizure control in patients who have not responded well to monotherapy.

Pregabalin is used to treat generalized anxiety disorder (GAD), a disorder characterized by excessive and uncontrollable worry about all aspects of daily life. The drug's anxiolytic effects are attributed to its action on calcium channels, which reduces the release of excitatory neurotransmitters that cause anxiety.

Pregabalin is used to treat postoperative pain, particularly in patients undergoing surgery with a higher risk of nerve damage, such as spinal or orthopedic surgery. Taking pregabalin before surgery can help reduce acute postoperative pain and reduce the need for opioid analgesics. This use can help more effectively control pain while reducing the side effects of opioid use.

Pregabalin is sometimes used to prevent migraine, a condition characterized by severe headaches often accompanied by nausea and sensitivity to light or sound. Although not officially approved to treat the condition, some patients have experienced a reduction in the frequency and severity of migraine headaches with pregabalin, possibly due to its modulation of neural activity involved in migraine pathophysiology.

References

2008. Effect of Morphine and Pregabalin Compared With Diphenhydramine Hydrochloride and Placebo on Hyperalgesia and Allodynia Induced by Intradermal Capsaicin in Healthy Male Subjects. The Journal of Pain, 9(12).
DOI: 10.1016/j.jpain.2008.05.013

2007. Pregabalin Augmentation of Quetiapine Therapy in the Treatment of Fibromyalgia: An Open-Label, Prospective Trial. Pharmacopsychiatry, 40(2).
DOI: 10.1055/s-2007-972572

2003. Pregabalin for the treatment of postherpetic neuralgia: a randomized, placebo-controlled trial. Neurology, 60(8).
DOI: 10.1212/01.wnl.0000055433.55136.55