Pregabalin is recommended by the National Institute for Health and Care Excellence (NICE) as one of the first-line options for neuropathic pain (except for trigeminal neuralgia) in adults, along with gabapentin, amitriptyline and duloxetine5. Amira Guirguis, MPharm programme director at Swansea University and an expert in novel psychoactive substances, adds that the potency of pregabalin might explain prescribers’ preference for it over gabapentin. “Across various studies, pregabalin consistently demonstrates a greater potency than gabapentin3. This discrepancy in potency is likely attributed to differences in their respective pharmacokinetic profiles,” she says, with pregabalin being absorbed more rapidly and achieving a higher bioavailability. But a marked increase in the number of deaths linked to the drugs triggered their reclassification as a Class C controlled drug in April 2019, which introduced greater restrictions on prescribing. This observational drug utilisation study (DUS) analysed pregabalin prescription data from the UK Health Improvement Network primary care database between September 2004 and July 2009.
Materials and methods
- The assay results for these capsules showed concentrations much lower than expected.
- But a marked increase in the number of deaths linked to the drugs triggered their reclassification as a Class C controlled drug in April 2019, which introduced greater restrictions on prescribing.
- Additionally, the obtained raw materials packaged in capsules were examined to understand their intended marketing.
- Research shows that the rate of patients newly treated with gabapentinoids tripled between 2007 and 2017 in primary care in the UK1.
- Research suggests that gabapentinoids alone rarely cause death, but clinically-relevant doses can be fatal, possibly owing to their reducing of tolerance to opioids11.
In this study, 40 seized samples (powder and capsule samples) were analysed using UPLC instrumentation. Additionally, the obtained raw materials packaged in capsules were examined to understand their intended marketing. The content of these capsules had been adulterated, with adulterated samples showing concentrations inconsistent with registered amounts at the regulatory bodies.
Recent studies have well-documented PGL misuse, particularly among polydrug users and opioid-dependent individuals (Kriikku and Ojanperä, 2021). To that end, some regulatory warnings and mortality data have further confirmed its abuse potential (Mathieson et al., 2020; Elliott et al., 2017). On the other side, the results of the PGL assay for the seized capsule samples (Figure 5C) using the UPLC-PDA method are shown in Table 5.
Discover content
The results revealed that five capsule samples containing PGL exceeded the range of 95%–105%, which is recommended by the BP. While most samples (68.57%) fell within the BP-recommended range (95%–105%), six showed the content of PGL below the range of 95%–105%. A control chart of the PGL contents following the BP limits is depicted in Figure 6.
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UPLC-PDA analysis of three independent preparations of each seized pregabalin powder sample. Pregabalin (PGL) is a medication that is prescribed buy pregabalin online for controlling specific neurological-related symptoms. Due to its abuse in multiple countries, PGL has been classified as a controlled substance by authorities, including the Saudi Food and Drug Authority (SFDA).
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