U.K. Implements Stricter Rules for Gabapentin, Pregabalin Prescriptions

Gabapentin and pregabalin now have more restrictive rules for prescriptions in the United Kingdom.

Because of concerns regarding the medications’ misuse, both were classified as class C controlled medicines. It is now illegal to supply, sell, or possess these medicines without a prescription, according to a news release by the Multiple Sclerosis (MS) Trust U.K.

Gabapentin is sold as Neurontin (Pfizer) and other different brand names in the U.S. In the U.K. and U.S., pregabalin is sold as Lyrica (Pfizer), and in the U.K. as Alzain (Reddy’s Laboratories).

The U.K. National Health Service (NHS) implemented the new rules for gabapentin and pregabalin prescriptions April 1.

Gabapentin was first developed to combat epilepsy seizures, but it can also help MS patients control pain and spasticity. Pain management effects of gabapentin result from its chemical properties, which calm hyperactive neurons.

Pregabalin is an anti-seizure medicine that is also used in the treatment of nerve pain in MS. The therapy slows down nerve signals involved in feeling pain.

Because the pain felt by MS patients is originated by nerve damage, patients rarely get relief from over-the-counter painkillers. Medicines such as Neurontin, Alzain, and Lyrica, which act on the central nervous system, are more effective.

These medicines help control pain that arises from the nerves; however, they do not cure MS.

Reports on the medicines’ misuse are increasing. They are used as recreational drugs, frequently in combination with opioids, and are associated to a high rate of death by overdose. Although not very potent on their own, the increased recreational popularity of these therapies could be linked to their availability and lower cost.

U.K. doctors will now provide a prescription for gabapentin and pregabalin that is valid for up to 30 days, meaning that MS patients or caretakers will need to request prescriptions every month.

If the general practitioner does not use electronic submission for controlled drugs, prescriptions must be picked up in person. In some cases, the doctor will no longer be able to submit the prescription electronically. After prescription, the patient or representative must pick up the medicine within 28 days. At the pharmacy, the patient or caretaker will be asked for a signature and proof of identity.

Measures to restrict access to gabapentin and pregabalin are expected to help prevent deaths associated with their misuse in the U.K. The NHS offers a patient leaflet explaining these changes in prescription rules.