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Lyrica - Compound vs tablet

I made a mistake calling Pregabalin a generic for Lyrica. However, Lyrica is being compounded in a liquid form at Texas A&M.
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Oh don't worry, that isn't an issue. Every brand name also has a 'common' or generic name regardless of whether it is actually available AS a generic (y) --but I am still really confused as pregabalin is as far as I know, NOT available as a generic and won't be for a couple of years -- it is still under patent restrictions. So I cannot understand how it is possible to get it at a cost that is less than gabapentin costs many of us. I am wondering if this is under some study being done through Texas A&M.

Are you saying your cavalier was on only 60mg doses of gabapentin? That would be extremely low -- my fellow is now on 200mg 3x.

I was quoted €148 for 56 25mg capsules for Lyrica/pregabalin in Ireland -- meds here tend to cost more. If I switched to this I'd probably have my partner get it in N. Ireland.
 
Karlin said:
-- my fellow is now on 200mg 3x.
I was quoted €148 for 56 25mg capsules for Lyrica/pregabalin in Ireland --.
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Karlin, can I understand from the above that if you switched your dog over to Lyrica, he would be on a lower dosage than he currently is with gabapentin? I ask because Bosco changed to Lyrica a month or so ago, and he is on the same original dosage. I have a feeling I need to speak to my vet about this because I think someone else mentioned previously about their dog being on a lower dosage of Lyrica vs gabapentin.
 
Charlifarley said:
Karlin, can I understand from the above that if you switched your dog over to Lyrica, he would be on a lower dosage than he currently is with gabapentin?
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It's a completely different drug so you can't compare. Dylan was on 150mg gabapentin 3 times a day and is now on 50mg Pregabalin twice a day.
 
Karlin said:
Are you saying your cavalier was on only 60mg doses of gabapentin? That would be extremely low -- my fellow is now on 200mg 3x.
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Flash is getting 60 mg of Pregabalin (Lyrica) 3X a day.

Our bottle reads 25mg/ml
Flash gets .08ml every 8 hours... If I figured it right that make it 60mg of Pregabalin every 8 hours. That's odd it is "low". Last time I called the neuro because his symptoms were worse she said she hated to up it to .08 because it can start to make them really groggy and start sedating him. (It hasn't) She recommended we start thinking of surgery if his symptoms continue to get worse rather then keep raising the dosage of his meds. I'm confused if his dosage is "low" why our neuro doesn't seem interested in raising it much more. Maybe because he is a puppy? He is still only 9 months old.
 
If I figured it right that make it 60mg of Pregabalin every 8 hours.
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That is actually very high if 60mg 3x. Note I was talking of 200mg *gabapentin* (Neurontin), not Lyrica (pregabalin). Most dogs start on 25 mg 2x, maybe going up to 50mg 2x. I had thought I understood from Clare that it doesn't benefit them to get this drug more than twice daily? I don't know how much higher you could go safely for his size or without having serious side effects. But I am not sure if you are calculating that correctly -- it would be worth checking what the actual individual dose of Lyrica is.

To be honest: if you are on very high doses of Lyrica -- which is really the last option except for introducing additional serious painkillers on top -- and he is only 9 months -- I'd opt for the surgery. The prognosis for medication treatment for early onset dogs, especially if early onset before one year, is very poor according to Clare's figures and research.

There are many reasons to opt for medications and not surgery but I think you are probably looking at a limited time of palliative care for Flash if you choose to continue on meds alone. He is very young to already be on at the maximum of what he can be treated with and not much works after Lyrica except perhaps adding in steroids for whatever time might be possible. I don't know how familiar your neurologist or you are with Clare's papers on this and the overall statistics that comeback, but Flash would by any measure I know of, be considered a very serious early onset case.
 
Karlin, can I understand from the above that if you switched your dog over to Lyrica, he would be on a lower dosage than he currently is with gabapentin?
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Oh goodness yes -- should generally start on only 25mg 2x and some are on lower than that I think. It is a much stronger drug.

For Flash and Bosco: this is Clare's treatment diagram:

http://www.veterinary-neurologist.co.uk/syringomyelia/docs/treatalgo.pdf

But she doesn't give suggested doses for Lyrica. I have spoken to her about it for Leo though and one advantage is that it is a much lower dosage and know the general starting point is around 25mg 2x.

Note that after Lyrica the option is steroids or surgery. For a young dog seriously affected dog who keeps declining (eg keeps needing medications increased), there are not many medication options left. Most neurologists I know of would recommend surgery for an early onset severely affected dog.
 
Karlin said:
That is actually very high if 60mg 3x. Most dogs start on 25 mg 2x, maybe going up to 50mg 2x. I had thought I understood from Clare that it doesn't benefit them to get this drug more than twice daily? I don't know how much higher you could go safely for his size or without having serious side effects. But I am not sure if you are calculating that correctly -- it would be worth checking what the actual individual dose of Lyrica is.

To be honest: if you are on very high doses of Lyrica -- which is really the last option except for introducing additional serious painkillers on top -- and he is only 9 months -- I'd opt for the surgery. The prognosis for medication treatment for early onset dogs, especially if early onset before one year, is very poor according to Clare's figures and research.

There are many reasons to opt for medications and not surgery but I think you are probably looking at a limited time of palliative care for Flash if you choose to continue on meds alone. He is very young to already be on at the maximum of what he can be treated with and not much works after Lyrica except perhaps adding in steroids for whatever time might be possible. I don't know how familiar your neurologist or you are with Clare's papers on this and the overall statistics that comeback, but Flash would by any measure I know of, be considered a very serious early onset case.
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Okay, that makes more since as to what our neurologist was saying. We are going to be forced to do the surgery this year. I'm thinking once we get our tax return back (another month or two). This is because A & M requires at least 1/2 payment upfront and our insurance takes a good week to process the claim and get the check back in the mail.

I am VERY scared of the surgery. I know that is our only option but that will be a completely different thread really soon.
 
Reptigirl said:
Our bottle reads 25mg/ml
Flash gets .08ml every 8 hours... If I figured it right that make it 60mg of Pregabalin every 8 hours.
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No! You've got your maths wrong.

25mg/ml means there is 25mg of pregabalin per ml.

You are giving only 0.08ml. (eight hundredths of 25mg)

So divide 25ml by 100 then multiply by 8.

Your answer is 2mg. No wonder it's not working.
 
I am not sure that that is the case with compounded liquid Pauline... I was confused over such measurements on Metacam. I cannot believe a dog would be given 2mg -- that would be pointless.

It would be best to call the vet and find out what dosage you are giving.

I checked and stand corrected on dosages: am told some dogs are on pregabalin 3 or 4x and many are on over 50mg each time so there is a wide variation depending on symptoms and weight of the dog.

I was given this link too:

http://www.vet.cornell.edu/news/articles/09pregabalin.cfm

Hope that helps.

Surgery is a hard decision but if I had a dog under 5 showing the symptoms you have I'd opt for surgery. I wouldn't even hesitate with a 9 month old and would move asap to limit damage that cannot be remedied, unless there were indications that the dog was a poor candidate. Now that is *my own* perspective but I think a neurologist will tell you the prognosis is very poor for a dog that is severely symptomatic and worsening at under one year. Many however would feel that palliative care was what they wished to offer and that is a valid choice too. I am just giving my own perspective.
 
*Pauline* said:
No! You've got your maths wrong.

25mg/ml means there is 25mg of pregabalin per ml.

You are giving only 0.08ml. (eight hundredths of 25mg)

So divide 25ml by 100 then multiply by 8.

Your answer is 2mg. No wonder it's not working.
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Sorry, that was supposed to be .8 ml

Typing too fast for my own good.
 
I think check again with your vet?
At 0.8 ml,he's getting 20 mg in that amount.
If he's supposed to get three doses in 24 hours,that's a total of 60 mg.
If he's supposed to get 60 mg, three times in 24 hours,then he needs a total of 180 mg,so your dosage should be 2.4 mls instead of 0.8mls?
But please check your dosage and formulation with your vet before making any adjustments.
Sins
 
Thanks for doing the maths this time Sinead ;)

Yes, then that dose is still very low. Certainly he could be on a lot more before I would even consider surgery.

Dylan gets 50mg twice a day and it was a miracle drug for him. Over night he transformed xx
 
From what I have read, the patent for Lyrica does not expire until October 2013, until then be aware that any medicine sold claiming to be generic Lyrica may be fake, therefore substandard and potentially dangerous.

http://epilepsy.emedtv.com/lyrica/generic-lyrica.htmlimproved

I also understood, Lyrica works in a similar way to Gabapentin. Lyrica is the improved version and is more potent, therefore the dose will be lower. I have found this article, if you read from "A Successor to Gabapentin"

www.drugdevelopment-technology.com/projects/pregabalin/
 
Wow that is great that A & M is giving out pregablin at such a low cost. Jack isn't on Lyrica but may need it in the future.
I too thought it was under patent until 2013. Anne did your vet get a hold of the vets at A & M and ask if it is offered at other vet schools at such a low rate? I know Dr. Dewy at Cornell did a study with A & M a couple of years ago (think 2009) looking at the effects of pregablin on epilepsy in dogs. So maybe Cornell might have access too?
 
My neurologist has not gotten back to me on a couple of things :( her vet said its illegal to cross state lines but I don't have much faith in some things he says.

I am upset b/c I really wanted to discuss more about some things. I will call to set up another acupuncture apt, maybe then I can ask him

Sent from my Droid using Tapatalk
 
Wow, can't believe you haven't gotten answers yet. I'd press the neuro to talk to you over the phone. The dose of those meds is all wrong, therefore your dog is in pain!
 
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