Difference Between Gabapentin and Pregabalin

Gabapentin and Pregabalin are anti-epileptic drugs that are used to control epilepsy and nerve discomfort. Anti-epileptic medicines are a class of medications intended to cure epileptic fits. They are also being used more often in the treatment of bipolar illness and borderline personality disorder because of their mood stabling properties.

Gabapentin vs Pregabalin

The main difference between Gabapentin and Pregabalin is that Gabapentin is used as an additional therapy for myoclonic seizures and peripheral neuropathic pain, whereas Pregabalin is used for nearly the same reasons, but it is also used to treat chronic fatigue syndrome and neuropathic pain associated with type 2 diabetes, particularly diabetic neuropathy.

Gabapentin vs Pregabalin

Gabapentin belongs to the anticonvulsant drug family. Gabapentin capsules, pills, and oral solutions are prescribed in conjunction with other drugs to assist patients with epilepsy and other types of seizures. It relieves seizures by reducing aberrant brain activity. It is also used to control neuropathic discomfort. Gabapentin reduces discomfort by changing how the brain senses pain.

Pregabalin is used to treat neuropathic pain in the limbs, wrists, fingers, thighs, toes, or soles in people with type 2 diabetes and postherpetic neuralgia. Pregabalin pills and liquid solutions are usually used in the treatment of fibromyalgia and to alleviate nerve discomfort induced by a spinal cord injury.

Comparison Table Between Gabapentin and Pregabalin

Parameters of comparisonGabapentinPregabalin
Use casePeripheral neuropathic pain and Migraine prophylaxisPeripheral and central neuropathic pain
Dose Range1200-1300mg/day300-600mg/day
Time to Cmax/Bioavailability2-3 hours/60%1 hour/>90%
PotencyLess potent2- 6 times more potent
Half-life5-7 hours6.3 hours

What is Gabapentin?

Gabapentin is a prescription medication. It is accessible as an oral pill, an instant pill, prolonged pills, and a liquid solution. The brand-name medicine Neurontin contains gabapentin oral capsules. It’s also accessible as a generic drug. Generic drugs are frequently less costly than brand-name prescription drugs. In certain circumstances, the brand-name and generic versions of the same medicine may be offered in different versions and intensities.

Gabapentin belongs to the anticonvulsant medication class. A drug class is a set of pharmaceuticals that function in the same way. These drugs are frequently used to address conditions that are comparable. It is unclear exactly how gabapentin functions. It appears to prevent the increase in pain sensitivity that happens with postherpetic neuralgia. In the case of seizures, it may affect the impact of calcium.

Gabapentin pills, capsules, and oral solutions are commonly consumed two to three times per day, with or without meals, with at 8 ounces of water for optimal results. These medications must be consumed at periodic intervals throughout the day and night, with a maximum of 12 hours between consecutive doses. The extended-release tablet is consumed daily with food. 

Gabapentin is also used to cure menopausal symptoms like rapid and powerful feelings of fever and perspiring in women undergoing treatment for breast and prostate cancer, as well as those who have gone through menopause and hormone imbalances such as the termination of periodic menstrual cycles.

What is Pregabalin?

Pregabalin is a prescription drug. It comes in three different configurations: pill, liquid, and extended-release tablet. All forms are administered orally. Lyrica is the marketing term for the pregabalin oral dosage form. Pregabalin oral tablet can be combined with other drugs. As a result, you may need to take it in tandem with certain other drugs. Pregabalin is a Schedule II-restricted drug. Your doctor will regularly monitor how you take this medication.

Pregabalin oral pill is used to treat nerve pain caused by peripheral nerve damage caused by diabetes, shingles, or spinal cord injury, as well as fibromyalgia, which is widespread discomfort, and partial-onset seizures in patients of age 1 month and older when combined with other seizure medications.

Pregabalin oral pill may induce vertigo, drowsiness, and blurred vision. It might impair your capacity to think, hear, or manoeuvre. You should not drive, operate equipment, or perform other duties that require awareness unless you know how this medication impacts you. Other adverse effects of Pregabalin include dry mouth, excess weight gain, and swelling of the hands or feet.

If the adverse symptoms are modest, they usually go away in a matter of days or weeks. If symptoms worsen or do not go away, see a medical professional. Pregabalin oral capsule may interfere with any drugs, vitamins, or herbs that you are currently taking. An interaction occurs whenever any substance modifies the manner in which a medicine acts. This can be hazardous or hinder the medication from functioning correctly.

Main Differences Between Gabapentin and Pregabalin

  • The binding affinity and potency of gabapentin and pregabalin differ. Gabapentin has a weaker sensitivity to the alpha-2-delta enzyme when compared to pregabalin, and hence pregabalin provides greater relief from acute nerve pain.
  • Gabapentin outperforms pregabalin in terms of reducing leg pain intensity while causing fewer side effects.
  • Gabapentin does show some side effects, however, pregabalin is more likely to induce adverse symptoms such as dry mouth, constipation, swelling, breast enlargement, or weight gain.
  • Gabapentin has a slow absorption rate and functions slower than pregabalin. Consequently, gabapentin requires 3 to 4 hours to reach maximum levels, whereas pregabalin reaches maximum levels within an hour of dosing.
  • Because of its slower absorption and commencement of effect, gabapentin has a lower addiction risk than pregabalin.
  • Although both medicines have comparable interactions, gabapentin may also interact with non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, and diclofenac, whereas no such interactions were observed in the case of pregabalin.

Conclusion

Although the pharmacokinetics and pharmacodynamics characteristics of gabapentin and pregabalin are similar, there are noticeable variances. Pregabalin has more consistent bioavailability in general, and also a higher adsorption affinity to its target receptor, enhanced effectiveness, and a higher dose-response slope in acute nerve discomfort that does not peak at recommended dose rates.

According to some research, pregabalin has milder side symptoms than gabapentin and therefore it is more helpful for neuropathic pain. Multiple pieces of research on the conversion of gabapentin to pregabalin suggest a rough conversion ratio of roughly 6:1 gabapentin to pregabalin. Furthermore, a direct move from gabapentin to pregabalin appears to be well tolerated, making the transfer uncomplicated.

References

  1. https://www.sciencedirect.com/science/article/pii/S1471489205001906
  2. https://link.springer.com/article/10.2165/11536200-000000000-00000
  3. https://journals.lww.com/anesthesia-analgesia/FullText/2012/08000/The_Prevention_of_Chronic_Postsurgical_Pain_Using.30.aspx
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