Indication(s)
Treatment of neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, spinal cord injury and pain associated with fibromyalgia.
Formulary status
The Drug Advisory Committee (DAC) recommended that generic pregabalin be listed on persistent pain (02WS), central nervous system (03WS), head/ non-brain (04WS), chronic pain disability (23WS) and initial musculoskeletal (25WS) formularies.
The WSIB has decided to accept the DAC recommendation.
Generic pregabalin (strengths: 25mg, 50mg, 75mg, 150mg, 300mg) IS listed on WSIB formularies 02WS, 03WS, 04WS, 23WS, and 25WS.
Drug profile
Products available in Canada:
Lyrica®, generic pregabalin
Recommendation highlights
- An external, independent review of placebo-controlled studies has concluded that pregabalin is safe and effective in reducing pain scores.
- Studies comparing pregabalin to other pain relieving medication for chronic non-cancer pain are limited. There is no evidence demonstrating any clear therapeutic or safety advantage of other effective agents over pregabalin (e.g. gabapentin, venlafaxine, tri-cyclic antidepressants (TCAs).
- Dizziness and somnolence are the most commonly reported adverse events; other frequently reported events include peripheral edema, dry mouth, weight gain, blurred vision, and abnormal thinking. Information on long-term safety and efficacy of pregabalin (over 24 weeks) is lacking.
- Canadian and international guidelines for CNCP generally recommend TCAs, duloxetine, gabapentin and pregabalin as effective, first-line treatment options in neuropathic pain and spinal cord injury. TCAs, all classes of antidepressants, pregabalin, and duloxetine are recommended in fibromyalgia.
- The DAC noted the heterogeneity of pharmacoeconomic studies and populations, which made cost-effectiveness of pregabalin difficult to interpret. The cost of generic pregabalin is comparable to other formulary alternatives in CNCP. The Ontario Drug Benefit Program lists generic pregabalin only.
- Based on the published evidence and the introduction of generic pregabalin, the DAC concluded that generic pregabalin is comparable to other CNCP formulary alternatives. Hence, the DAC recommended formulary addition of generic pregabalin.
Original date: Feb 13th, 2009
Revised: November 2nd, 2011
Updated: March 2nd, 2015
The WSIB will consider all relevant facts and circumstances, and shall make its decision based upon the merits and justice of a particular case.
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