Patient leaflet - Pregabalin Wockhardt 225 mg hard capsules
1. What pregabalin is and what it is used for
It contains Pregabalin which belongs to a class of medicines called Gabapentinoids.
This medicine has been prescribed to you and should not be given to anyone else.
Gabapentinoids can cause dependence, tolerance and addiction, and you may get withdrawal symptoms if you stop taking it or reduce the dose suddenly. Your prescriber should have explained how long you will be taking it for and, when it is appropriate to stop, how to do this safely. When your treatment is stopped, it is usually done gradually over a period which is specific to you and may occur over a period of weeks to months. If this medicine is being used for the treatment of epilepsy you must continue to take it as prescribed by your doctor.
Pregabalin belongs to a group of medicines used to treat epilepsy, neuropathic pain and Generalised Anxiety Disorder (GAD) in adults.
Peripheral and central neuropathic pain: pregabalin is used to treat long lasting pain caused by damage to the nerves. A variety of diseases can cause peripheral neuropathic pain, such as diabetes or shingles. Pain sensations may be described as hot, burning, throbbing, shooting, stabbing, sharp, cramping, aching, tingling, numbness, pins and needles. Peripheral and central neuropathic pain may also be associated with mood changes, sleep disturbance, fatigue (tiredness), and can have an impact on physical and social functioning and overall quality of life.
Epilepsy: pregabalin is used to treat a certain form of epilepsy (partial seizures with or without secondary generalisation) in adults. Your doctor will prescribe pregabalin for you to help treat your epilepsy when your current treatment is not controlling your condition.
You should take pregabalin in addition to your current treatment. pregabalin is not intended to be used alone, but should always be used in combination with other anti-epileptic treatment.
Generalised Anxiety Disorder: pregabalin is used to treat Generalised Anxiety Disorder (GAD). The symptoms of GAD are prolonged excessive anxiety and worry that are difficult to control. GAD can also cause restlessness or feeling keyed up or on edge, being easily fatigued (tired), having difficulty concentrating or mind going blank, feeling irritable, having muscle tension or sleep disturbance. This is different to the stresses and strains of everyday life.
2. What you need to know before you take pregabalin
Do not take pregabalin
If you are allergic to pregabalin or any of the other ingredients of this medicine (listed in section 6).
Warnings and precautions
Talk to your prescriber before taking this medicine if you:
- are or have ever been addicted to opioids, alcohol, prescription medicines, or illegal drugs, or if you have ever had a history of struggling to control your alcohol or drug intake.
- have previously suffered from withdrawal symptoms such as agitation, anxiety, shaking or sweating, when you have stopped taking alcohol or drugs.
- feel you need to take more of Pregabalin Wockhardt Hard Capsules to get the same level of symptom control, this may mean you are developing tolerance to the effects of this medicine or are becoming addicted to it. Speak to your prescriber who will discuss your treatment and may change your dose or switch you to an alternative medication.
Taking this medicine regularly, particularly for a long time, can lead to physical dependence and addiction. Your prescriber should have explained how long you will be taking it for and, when it is appropriate to stop, how to do this safely. When your treatment is stopped, it is usually done gradually over a period which is specific to you and may occur over a period of weeks to months.
Physical dependence and addiction can cause withdrawal symptoms when you stop taking this medicine. Withdrawal symptoms can include:
- trouble sleeping, headache, nausea, feeling anxious, diarrhoea, flu-like symptoms, convulsions, nervousness, depression, thoughts of harming or killing yourself, pain, sweating, and dizziness.
Your prescriber will discuss with you how to gradually reduce your dose before stopping the medicine. It is important that you do not stop taking the medicine suddenly as you will be more likely to experience withdrawal symptoms. Your prescriber will ensure that your plan for stopping treatment is tailored to you and can be adapted according to your needs and experience of any withdrawal symptoms.
- Some patients taking pregabalin have reported symptoms suggesting an allergic reaction. These symptoms include swelling of the face, lips, tongue, and throat, as well as diffuse skin rash. Should you experience any of these reactions, you should contact your physician immediately
- Serious skin rashes including Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported in association with pregabalin. Stop using pregabalin and seek medical attention immediately if you notice any of the symptoms related to these serious skin reactions described in section 4
- Pregabalin has been associated with dizziness and somnolence, which could increase the occurrence of accidental injury (fall) in elderly patients. Therefore, you should be careful until you are used to any effect the medicine might have
- Pregabalin may cause blurring or loss of vision, or other changes in eyesight, many of which are temporary. You should immediately tell your doctor if you experience any changes in your vision
- Some patients with diabetes who gain weight while taking pregabalin may need an alteration in their diabetic medicines
- Certain side effects may be more common, such as sleepiness, because patients with spinal cord injury may be taking other medicines to treat, for example, pain or spasticity, that have similar side effects to pregabalin and the severity of these effects may be increased when taken together
- There have been reports of heart failure in some patients when taking pregabalin; these patients were mostly elderly with cardiovascular conditions. Before taking this medicine you should tell your doctor if you have a history of heart disease
- There have been reports of kidney failure in some patients when taking pregabalin. If while taking pregabalin you notice decreased urination, you should tell your doctor as stopping the medicine may improve this
- Some patients being treated with anti-epileptics such as pregabalin have had thoughts of harming or killing themselves or shown suicidal behaviour. If at any time you have these thoughts or show such behaviour, immediately contact your doctor
- When pregabalin is taken with other medicines that may cause constipation (such as some types of pain medicines) it is possible that gastrointestinal problems may occur (e.g., constipation, blocked or paralysed bowel). Tell your doctor if you experience constipation, especially if you are prone to this problem
- Before taking this medicine, tell your doctor if you have ever abused or been dependent on alcohol, prescription medicines or illegal drugs; it may mean you have a greater risk of becoming dependent on pregabalin
- There have been reports of convulsions when taking pregabalin or shortly after stopping pregabalin. If you experience a convulsion, contact your doctor immediately
- There have been reports of reduction in brain function (encephalopathy) in some patients taking pregabalin when they have other conditions. Tell your doctor if you have a history of any serious medical conditions, including liver or kidney disease
- There have been reports of breathing difficulties. If you have nervous system disorders, respiratory disorders, renal impairment, or you are older than 65, your doctor may prescribe you a different dosing regimen. Contact your doctor if you experience trouble breathing or shallow breaths.
Dependence
Some people may become dependent on pregabalin (a need to keep taking the medicine). They may have withdrawal effects when they stop using pregabalin (see section 3, “How to take pregabalin” and “If you stop taking pregabalin”). If you have concerns that you may become dependent on pregabalin, it is important that you consult your doctor.
If you notice any of the following signs whilst taking pregabalin, it could be a sign that you have become dependent:
- You need to take the medicine for longer than advised by your prescriber
- You feel you need to take more than the recommended dose
- You are using the medicine for reasons other than prescribed
- You have made repeated, unsuccessful attempts to quit or control the use of the medicine
- When you stop taking the medicine you feel unwell, and you feel better once taking the medicine again.
If you notice any of these, speak to your doctor to discuss the best treatment pathway for you, including when it is appropriate to stop and how to do this safely.
Children and adolescents
The safety and efficacy in children and adolescents (under 18 years of age) has not been established and therefore, pregabalin should not be used in this age group.
Other medicines and pregabalin
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Pregabalin and certain other medicines may influence each other (interaction). When taken with certain other medicines which have sedative effects (including opioids), pregabalin may potentiate these effects, and could lead to respiratory failure, coma and death. The degree of dizziness, sleepiness and decreased concentration may be increased if pregabalin is taken together with medicines containing:
Oxycodone – (used as a pain-killer)
Lorazepam – (used for treating anxiety)
Alcohol
Pregabalin may be taken with oral contraceptives.
Pregabalin with food, drink and alcohol
Pregabalin Wockhardt Hard Capsules may be taken with or without food. It is advised not to drink alcohol while taking pregabalin.
Pregnancy and breast-feeding
- If you are pregnant, or think you may be pregnant, you must tell your doctor straight away and discuss possible risks the medicine you are taking might pose to your unborn baby
- If you are planning to become pregnant you should discuss your treatment with your doctor as early as possible before you become pregnant
- You should not stop your treatment without discussing this with your doctor.
Pregnancy
Pregabalin should not be taken during pregnancy or when breast-feeding, unless you are told otherwise by your doctor. Pregabalin use during the first 3 months of pregnancy may cause birth defects in the unborn child that require medical treatment, In a study reviewing data from women in Nordic countries who took pregabalin in the first 3 months of pregnancy, 6 babies in every 100 had such birth defects. This compares to 4 babies in every 100 born to women not treated with pregabalin in the study. Abnormalities of the face (orofacial clefts), the eyes, the nervous system (including the brain), kidneys and genitals have been reported.
Effective contraception must be used by women of child-bearing potential. There has been limited research specifically looking at the use of pregabalin in pregnant women.
More research is needed to better understand and inform on the safety of use of pregabalin during pregnancy and whether it is associated with an increased risk of harm to the unborn child.
Driving and using machines
Pregabalin may produce dizziness, sleepiness and decreased concentration. You should not drive, operate complex machinery or engage in other potentially hazardous activities until you know whether this medicine affects your ability to perform these activities.
Pregabalin Wockhardt Hard Capsules contains lactose monohydrate
If you have been told by your doctor that you have intolerance to some sugars, contact your doctor before taking this medicinal product.
3. How to take pregabalin
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. Do not take more medicine than prescribed.
Your doctor will determine what dose is appropriate for you.
Your prescriber should have discussed with you how long the course of Pregabalin Wockhardt Hard Capsules will last. They will arrange a plan for stopping treatment. This will outline how to gradually reduce the dose and stop taking the medicine. Your prescriber will ensure that your plan for stopping treatment is tailored to you and can be adapted according to your needs and experience of any withdrawal symptoms.
If you stop taking Pregabalin Wockhardt Hard Capsules
Do not suddenly stop taking this medicine. If you want to stop taking this medicine, discuss this with your prescriber first. They will tell you how to do this, usually by reducing the dose gradually so that any unpleasant withdrawal effects are kept to a minimum. This may occur over a period of weeks to months. Your prescriber will ensure that your plan for stopping treatment is tailored to you and can be adapted according to your needs and experience of any withdrawal symptoms.
Withdrawal symptoms such as:
- trouble sleeping, headache, nausea, feeling anxious, diarrhoea, flu-like symptoms, convulsions, nervousness, depression, thoughts of harming or killing yourself, pain, sweating, and dizziness.
Pregabalin Wockhardt Hard Capsules are for oral use only.
Peripheral and central neuropathic pain, epilepsy or Generalised Anxiety Disorder:
- Take the number of capsules as instructed by your doctor
- The dose, which has been adjusted for you and your condition, will generally be between 150 mg and 600 mg each day
- Your doctor will tell you to take pregabalin either twice or three times a day. For twice a day take pregabalin once in the morning and once in the evening, at about the same time each day. For three times a day take pregabalin once in the morning, once in the afternoon and once in the evening, at about the same time each day.
If you have the impression that the effect of pregabalin is too strong or too weak, talk to your doctor or pharmacist.
If you are an elderly patient (over 65 years of age), you should take pregabalin normally except if you have problems with your kidneys.
Your doctor may prescribe a different dosing schedule and/or dose if you have problems with your kidneys.
Swallow the capsule whole with water.
Continue taking pregabalin until your doctor tells you to stop.
If you take more pregabalin than you should
Call your doctor or go to the nearest hospital emergency unit immediately. Take your box or bottle of pregabalin capsules with you. You may feel sleepy, confused, agitated, or restless as a result of taking more pregabalin than you should. Fits and unconsciousness (coma) have also been reported.
If you forget to take pregabalin
It is important to take your pregabalin capsules regularly at the same time each day. If you forget to take a dose, take it as soon as you remember unless it is time for your next dose. In that case, just carry on with the next dose as normal. Do not take a double dose to make up for a forgotten dose.
If you stop taking pregabalin
Do not suddenly stop taking pregabalin. If you want to stop taking pregabalin, discuss this with your doctor first. They will tell you how to do this. If your treatment is stopped it should be done gradually over a minimum of 1 week. After stopping a short or long-term treatment with pregabalin, you need to know that you may experience certain side effects, so-called withdrawal effects. These effects include, trouble sleeping, headache, nausea, feeling anxious, diarrhoea, flu- like symptoms, convulsions, nervousness, depression, thoughts of harming or killing yourself pain, sweating, and dizziness. These effects may occur more commonly or severely if you have been taking pregabalin for a longer period of time. If you experience withdrawal effects, you should contact your doctor.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Very common: may affect more than 1 in 10 people
Dizziness, drowsiness, headache
Common: may affect up to 1 in 10 people
- Increased appetite
- Feeling of elation, confusion, disorientation, decrease in sexual interest, irritability
•Disturbance in attention, clumsiness, memory impairment, loss of memory, tremor, difficulty with speaking, tingling feeling, numbness, sedation, lethargy, insomnia, fatigue, feeling abnormal
- Blurred vision, double vision
- Vertigo, problems with balance, fall
- Dry mouth, constipation, vomiting, flatulence, diarrhoea, nausea, swollen abdomen
- Difficulties with erection
- Swelling of the body including extremities
- Feeling drunk, abnormal style of walking
- Weight gain
- Muscle cramp, joint pain, back pain, pain in limb
- Sore throat.
Uncommon: may affect up to 1 in 100 people
- Loss of appetite, weight loss, low blood sugar, high blood sugar
- Change in perception of self, restlessness, depression, agitation, mood swings, difficulty finding words, hallucinations, abnormal dreams, panic attack, apathy, aggression, elevated mood, mental impairment, difficulty with thinking, increase in sexual interest, problems with sexual functioning including inability to achieve a sexual climax, delayed ejaculation
- Changes in eyesight, unusual eye movement, changes in vision including tunnel vision, flashes of light, jerky movements, reduced reflexes, increased activity, dizziness on standing, sensitive skin, loss of taste, burning sensation, tremor on movement, decreased consciousness, loss of consciousness, fainting, increased sensitivity to noise, feeling unwell
- Dry eyes, eye swelling, eye pain, weak eyes, watery eyes, eye irritation
- Heart rhythm disturbances, increased heart rate, low blood pressure, high blood pressure, changes in heart beat, heart failure
- Flushing, hot flushes
- Difficulty breathing, dry nose, nasal congestion
- Increased saliva production, heartburn, numb around mouth
- Sweating, rash, chills, fever
- Muscle twitching, joint swelling, muscle stiffness, pain including muscle pain, neck pain
- Breast pain
- Difficulty with or painful urination, incontinence
- Weakness, thirst, chest tightness
- Changes in blood and liver test results (blood creatinine phosphokinase increased, alanine amino transferase increased, aspartate aminotransferase increased, platelet count decreased, neutropaenia, increase in blood creatinine, decrease in blood potassium)
- Hypersensitivity, swollen face, itchiness, hives, runny nose, nose bleed, cough, snoring
- Painful menstrual periods
- Coldness of hands and feet.
Rare: may affect up to 1 in 1,000 people
- Abnormal sense of smell, swinging vision, altered perception of depth, visual brightness, vision loss
- Dilated pupils, cross eyes
- Cold sweat, tightness of the throat, swollen tongue
- Inflammation of the pancreas
- Difficulty in swallowing
- Slow or reduced movement of the body
- Difficulty with writing properly
- Increased fluid in the abdomen
- Fluid in the lungs
- Convulsions
- Changes in the recording of electrical changes (ECG) in the heart which correspond to heart rhythm disturbances
- Muscle damage
- Breast discharge, abnormal breast growth, breast growth in males
- Interrupted menstrual periods
- Kidney failure, reduced urine volume, urinary retention
- Decrease in white blood cell count
- Inappropriate behaviour, suicidal behaviour, suicidal thoughts
- Allergic reactions which may include difficulty breathing, inflammation of the eyes (keratitis) and serious skin reactions characterized by reddish non-elevated, target-like or circular patches on the trunk, often with central blisters, skin peeling, ulcers of mouth, throat, nose, genitals and eyes. These serious skin rashes can be preceded by fever and flu-like symptoms (Stevens-Johnson syndrome, toxic epidermal necrolysis)
- Jaundice (yellowing of the skin and eyes)
- Parkinsonism, that is symptoms resembling Parkinson’s disease; such as tremor, bradykinesia (decreased ability to move), and rigidity (muscle stiffness).
Very rare: may affect up to 1 in 10,000 people
- Liver failure
- Hepatitis (inflammation of the liver).
Not known: frequency cannot be estimated from the available data
- Becoming dependent on pregabalin (‘drug dependence’).
After stopping a short or long-term treatment with pregabalin, you need to know that you may experience certain side effects, so-called withdrawal effects (see “If you stop taking pregabalin”).
Unknown frequency: dependence and addiction (see section “How do I know if I am tolerant or addicted?”).
Drug Withdrawal
When you stop taking Pregabalin Wockhardt Hard Capsules, you may experience drug withdrawal symptoms, which include:
- trouble sleeping, headache, nausea, feeling anxious, diarrhoea, flu-like symptoms, convulsions, nervousness, depression, thoughts of harming or killing yourself, pain, sweating, and dizziness.
How do I know if I am tolerant or addicted?
If you notice any of the following signs whilst taking Pregabalin Wockhardt Hard Capsules, it could be a sign that you have become addicted.
- You may feel the need to keep taking the medication for longer than your doctor recommended
- You feel you need to use more than the recommended dose
- You are using the medicine for reasons other than prescribed
- When you stop taking the medicine you feel unwell, and you feel better once taking the medicine again
If you notice any of these signs, it is important you talk to your prescriber.
If you experience swollen face or tongue or if your skin turns red and starts to blister or peel you should seek immediate medical advice.
Certain side effects may be more common, such as sleepiness, because patients with spinal cord injury may be taking other medicines to treat, for example, pain or spasticity, that have similar side effects to pregabalin and the severity of these effects may be increased when taken together.
The following adverse reaction has been reported in the postmarketing experience: Trouble breathing, shallow breaths.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or
Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
5. How to store pregabalin
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and blister after EXP. The expiry date refers to the last day of that month.
This medicinal product does not require any special storage conditions.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Pregabalin Wockhardt Hard Capsules contains
The active substance is pregabalin.
Each hard capsule contains either 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg or 300mg pregabalin.
The other ingredients are: lactose monohydrate, maize starch, talc (E553b), gelatine, titanium dioxide (E171) and black ink (which contains shellac, black iron oxide (E172), propylene glycol, potassium hydroxide).
The 50mg, 75mg, 100mg, 200mg, 225mg and 300mg capsules also contain red iron oxide (E172).
The 50mg, 200mg, 225mg capsules also contain yellow iron oxide (E172).
What Pregabalin Wockhardt Hard Capsules looks like and contents of the pack
25mg capsules
Hard capsules, size 4, with a white cap and a white body, with “25” printed in black ink on the body. The capsules contain a white to off-white powder.
50mg capsules
Hard capsules, size 3, with a white cap and a pinkish-orange body, with “50” printed in black ink on body. The capsules contain a white to off-white powder.
75mg capsules
Hard capsules, size 4, with a brownish-red cap and a white body, with “75” printed in black ink on the body. The capsules contain a white to off-white powder.
100mg capsules
Hard capsules, size 3, with a brownish-red cap and a brownish-red body, with “100” printed in black ink on the body. The capsules contain a white to off-white powder.
150mg capsules
Hard capsules, size 2, with a white cap and a white body, with “150” printed in black ink on the body. The capsules contain a white to off-white powder.
200mg capsules
Hard capsules, size 1, with a pinkish-orange cap and a pinkish-orange body, with “200” printed in black ink on the body. The capsules contain a white to off-white powder.
225mg capsules
Hard capsules, size 1, with a pinkish-orange cap and a white body, with “225” printed in black ink on the body. The capsules contain a white to off-white powder.
300mg capsules
Hard capsules, size 0, with a brownish-red cap and a white body, with “300” printed in black ink on the body. The capsules contain a white to off-white powder.
Pregabalin Wockhardt Hard Capsules, hard are available in PVC/Aluminium blisters containing 10, 14, 20, 21, 28, 30, 56, 60, 70 [for 75 mg only], 84, 90, 100 or 84 (multipack: 2 x 42), 112 (multipack: 2 x 56), 120 (multipack: 2 x 60), 200 (multipack: 2 x 100) hard capsules.
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Wockhardt UK Ltd, Ash Road North, Wrexham LL13 9UF, UK
Manufacturer
CP Pharmaceuticals Ltd, Ash Road North, Wrexham LL13 9UF, UK
Other formats:
To listen to or request a copy of this leaflet in Braille, large print or audio please call, free of charge: 0800 198 5000 (UK only).
Please be ready to give the following information:
| Product name | Reference number |
|---|---|
| Pregabalin Wockhardt 25mg Hard Capsules | 29831/0641 |
| Pregabalin Wockhardt 50mg Hard Capsules | 29831/0642 |
| Pregabalin Wockhardt 75mg Hard Capsules | 29831/0643 |
| Pregabalin Wockhardt 100mg Hard Capsules | 29831/0644 |
| Pregabalin Wockhardt 150mg Hard Capsules | 29831/0645 |
| Pregabalin Wockhardt 200mg Hard Capsules | 29831/0646 |
| Pregabalin Wockhardt 225mg Hard Capsules | 29831/0647 |
| Pregabalin Wockhardt 300mg Hard Capsules | 29831/0648 |
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