Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)


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Old 02-11-2008, 02:46 AM #1
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Default Lyrica - Maximum Dosage in Children ???

Hi there
Alison is currently taking 75mg of Lyrica three times daily
I collected our new prescription form my Pharmacy at the end of last week as our supply of Lyrica ran out over the weekend
When I opened the box I notice the tablets looked different and when I looked closer the Pharmacy had dispensed 200mg tablets so if I hadn't noticed Alison would have been taking 600mg a day
I have no idea if the mistake was made by our GP or the Pharmacy as both are closed over the weekend
Consequently Alison hasn't had her Lyrica over the weekend and has had trouble sleeping as a result (it makes no differnece to her pain)
I know the maximum dose for adults is 600mg daily but as Lyrica is not advised for use in children I have no idea what (if any) the recommended dosage should be
The drug manufacturers website states:
The safety and efficacy of pregabalin in pediatric patients have not been
established.
In studies in which pregabalin (50 to 500 mg/kg) was orally administered to
young rats from early in the postnatal period (Postnatal Day 7) through sexual
maturity, neurobehavioral abnormalities (deficits in learning and memory, altered
locomotor activity, decreased auditory startle responding and habituation) and
reproductive impairment (delayed sexual maturation and decreased fertility in
males and females) were observed at doses ≥50 mg/kg. The neurobehavioral
changes of acoustic startle persisted at ≥250 mg/kg and locomotor activity and
water maze performance at ≥500 mg/kg in animals tested after cessation of
dosing and, thus, were considered to represent long-term effects. The low effect
dose for developmental neurotoxicity and reproductive impairment in juvenile
rats (50 mg/kg) was associated with a plasma pregabalin exposure (AUC)
approximately equal to human exposure at the maximum recommended dose of
600 mg/day. A no-effect dose was not established.

Reading about reproductive imparement really scares me - what implications might taking this drug now have on Alisons future health and well-being !!!!
As I say, Alison never took the 600mg I prescribed but I have grave concerns about what would have happened if she had taken it
Any advice would be welcome - particularly any studies of the long term use of this drug in children
Thanks
Andrea
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Old 02-11-2008, 09:06 AM #2
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Andrea,
The dose of Lyrica which is appropriate for Ali is very dependent on her weight.
I presume that is what is the doctor is basing the dose on rather than her age.
As always check with her doctor if you are concerned and if the Pharmacy gave you the wrong dose tablet then this is a very serious issue and must be dealt with
I do hope she will be able to get into that Children's Pain Management program soon.At her young age it would be wonderful if she could manage her RSD without the use of medications and of course better still, be cured!
Cheers Tayla
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Old 02-11-2008, 10:24 AM #3
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Thanks Tayla
My GP phoned this morning after I rang his office first thing
It turns out that there has been a real mix up with the tablets
The actual dosage is 75mg three times daily as we were told by the consultant but in his letter to our GP he has written 225mg three times daily instead of "split over three doses" which is where the problem arose
I now have to go later and collect the correct prescription and hand over the 200mg tablets in favour of 75mg ones
As for the weight / dosage ratio, Alison weighs around 126lbs, 15 more than when she started on Lyrica so I suppose this is a small adult weight. Should she continue to gain weight on Lyrica we will have to rethink as she is obviously quite inactive due to her inability to walk at the moment
Best wishes
Andrea
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Sandel (02-11-2008)
Old 02-11-2008, 10:37 AM #4
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Good catch Mom
Good thing you trusted your instincts.
Hope Ali has a better week
Jeanne
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Old 02-11-2008, 04:55 PM #5
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Quote:
Originally Posted by ali12 View Post
Thanks Tayla
My GP phoned this morning after I rang his office first thing
It turns out that there has been a real mix up with the tablets
The actual dosage is 75mg three times daily as we were told by the consultant but in his letter to our GP he has written 225mg three times daily instead of "split over three doses" which is where the problem arose
I now have to go later and collect the correct prescription and hand over the 200mg tablets in favour of 75mg ones
As for the weight / dosage ratio, Alison weighs around 126lbs, 15 more than when she started on Lyrica so I suppose this is a small adult weight. Should she continue to gain weight on Lyrica we will have to rethink as she is obviously quite inactive due to her inability to walk at the moment
Best wishes
Andrea



Wow Andrea,
That is a really bad mistake I hope there is a warning sent to those responsible.
Is Ali getting any benefit from Lyrica Alison?
Love Tayla
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Old 02-11-2008, 05:31 PM #6
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Hi Tayla
The really scary thing is the letter came directly from Alisons Consultant !!!! Eeeek!!!!
I am always on my guard now as we have had a number of problems with meds before (funnily enough NEVER at home !!!)
The last time Alison was in hospital one of the nurses gave her amitriptylyne thinking it was baclofen and only the difference in colour made Alison notice
The time before that Alison complained of pain very early in the morning so they brought her tramadol forward and didn't mark it off her drugs card so tried to give her another dose at breakfast
The NHS staff are really overstretched here at times (not that that's an excuse) so it always makes us wary when Alison is in hospital, hence picking up on the consultants mistake
Thanks again and best wishes
Andrea
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