Download patient information leaflet - NHS Scarborough and Ryedale CCG

PATIENT INFORMATION LEAFLET – PREGABALIN AND
PAIN MANAGEMENT
Introduction
Pregabalin is available on the NHS as an option for the treatment of
epilepsy and nerve pain, known as neuropathic pain. It is not effective for
everyone and has potential for side effects, misuse and abuse.
Pregabalin is not licensed for treatment of other types of pain (pain caused
by injury/inflammation to skin, muscles, bones or joints).
Anyone taking Pregabalin should be reviewed regularly by their medical
team to ensure that it is being used safely and effectively.
Pregabalin has been identified as being a drug of abuse. There are
significant risks if it is taken in conjunction with many other medications
and painkillers (including codeine, methadone) and alcohol.
What is neuropathic pain?
Neuropathic pain is a pain that comes from problems with signals from the
nerves. There are various causes and it is often described as burning,
stabbing, shooting, aching, tingling, an electric shock or like a sensation of
pins and needles. It can be caused by various conditions, which can
commonly include the following:

Trigeminal neuralgia (severe pains in parts of the face)

Post herpetic neuralgia (pain after shingles)

Diabetic neuropathy - a nerve disorder that develops in some people
with diabetes

Trapped nerve

Phantom limb pain following an amputation.
Neuropathic pain can also occur in patients with cancer, multiple sclerosis
and other conditions.
How is neuropathic pain treated?
Neuropathic pain has to be treated with medicines which work on nerves
and the nervous system. It is difficult to treat because it is hard to find a
medicine that works well and traditional painkillers such as paracetamol,
anti-inflammatories and codeine do not help very much.
As the drugs to treat neuropathic pain can often have unpleasant side
effects it is necessary to start at a low dose and slowly increase the dose
until the desired effect is reached.
If after 8-12 weeks, the medicine is having no effect or the side effects are
too unpleasant, the dose will need to be gradually reduced and stopped as
another drug is started and the dose increased.
If the medicine is only slightly effective, we may add another medicine
gradually after the initial 8 -12 week period.
It is important that you follow the instructions when increasing and
decreasing your dose of medicine as this will help identify which medicine
is most suitable for you.
Once you have reached a dose that helps control the pain, and that you
can tolerate we will stop increasing the dose and you will remain on that
dose. Please let us know your progress and any problems you are having
with your medicine. It is important that you follow this gradual increase in
dose and also do not exceed the stated dose.
Side effects of treatment
Please read the patient information provide by the manufacturer of your
medicine. If you did not receive one when your medicine was dispensed,
then please ask your pharmacist for one. Gradually increasing the dose of
the medicine you are taking will help us see if you are able to tolerate the
medicine and ensure the final dose you take has the fewest side effects
with the greatest benefit.
Treatment Risks
If you are concerned that you may be at risk due to other factors in your
life such as alcohol dependency or substance misuse then please make an
urgent appointment to discuss this in confidence with your GP.
Your medication review
Once your treatment is stabilised, we will ask you to make an appointment
after 12 weeks (and then at regular intervals) to discuss the following
points. You may wish to use the short survey attached to think how you
have been feeling and in particular:






Whether your pain has improved and by how much.
Your general mood.
Whether you are sleeping well.
How you feel generally.
Whether you have been able to get back to something like your normal
life and start doing things you had to stop previously because of the
pain (jobs around the house, work, driving and social activities).
Any problems you have had with your medicines including side effects.
Based on what you discuss your doctor may suggest:



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A change in your medicine if it is not effective or causing problem side
effects- you may have to slowly decrease the dose of one medicine and
increase the other again (written information will be provided on how to
do this).
A referral to a specialist neuropathic pain clinic as your neuropathic pain
has not responded to treatments he has tried.
A trial to see whether you can manage with a lower dose – the dose will
be reduced gradually.
Whether your neuropathic pain has improved enough for your medicine
to be stopped altogether (again your dose will be reduced gradually).
More information
You can get further information and support from (fill in local details or
delete any not applicable).
Practice nurse telephone number:
[add telephone number]
Pain concern, helpline
0844 4994676
www.painconcern.org.uk
Patient experience record
Please use this feedback form to record how you have been feeling since starting to use Pregabalin
1. Has your pain improved?
Not at all
Small improvement
Don’t know
Good improvement
Excellent improvement
2. How is your general mood? How are you feeling in yourself?
No better
Small improvement
Don’t know
Good improvement
Excellent improvement
3. How are you sleeping?
Very badly
Badly
Don’t know
Quite well
Very well
4. Have you been able to start doing any of the things that you had to stop doing because of the pain?
Not at all
Sometimes
Don’t know
Often
Completely back to normal
5. Have you had any problems with your medication?
Not at all
Sometimes
Don’t know
Please provide details of any problems below
Often
All the time
6. Have you experienced any side-effects? These might include: dizziness, weight gain, nasal congestion, memory
problems, fatigue
Not at all
Sometimes
Don’t know
Please provide details below
7. Any other comments or concerns that you would like to raise?
Often
All the time