Lyrica falls short in 2 pain studies:

[mrsD]

This is from the RSD forum:

http://health.yahoo.net/news/s/nm/pf...o-pain-studies

[Spiney95]

I find it interesting that it has taken this long for this info. to reach the public. Certainly, Pfizer was aware of this but in no hurry for the public to become aware of it, particularly after the huge media campain touting it as an effective Fibro medication. I have been on it along with Gabitril for nerve pain and Fibro and have experienced modest relief. Frankly, I will take anything that is reasonable if it gives me some relief. I hate to read these results in light of the problems many have going off of it. I have had two episodes where my part D provider refused to pay for it and it took 4-6 weeks to get it straighted out in spite of my pain doc agressively advocating for me. Both times, I experienced severe withdrawl the entire time and I only take 75 mg bid.

[mrsD]

Lyrica is going generic soon.

Oct. 2013.. I believe a "new" Lyrica is in the works at Pfizer.

Here is a patent granted in 2010 for extended release of pregabalin.
http://www.faqs.org/patents/app/20100255067

The press releases do not say it was extended release or immediate release that failed. So this remains unclear. I can't find the studies on PubMed yet.

When a drug goes off patent the parent company often introduces it with a new patent as extended release.

Pfizer has been trying to increase insurance acceptability for Lyrica for chronic pain. This failure, is not going to get them
approved or paid for it appears.

Here is what the Pfizer reps (and their trolls) are saying:
http://www.cafepharma.com/boards/sho...d.php?t=501002
warning---- strong language as usual.

[zygopetalum]

Those are the people who are educating doctors about medications!!!????
No wonder......

judi

[mrsD]

I've been reading CafePharma for several years. Not everyday, because it is mostly unpleasant!

But it does illustrate the business very well. Sometimes it is revealing about mergers etc. I even went on several boards at times to ask a pertinent question, and was met with such venom! A simple question... not challenging in the least. It is quite the education IMO.

I think EVERY doctor should read those boards there. That would be a real wake-up call for them!

[Spiney95]

Originally Posted by mrsD

I've been reading CafePharma for several years. Not everyday, because it is mostly unpleasant!

But it does illustrate the business very well. Sometimes it is revealing about mergers etc. I even went on several boards at times to ask a pertinent question, and was met with such venom! A simple question... not challenging in the least. It is quite the education IMO.

I think EVERY doctor should read those boards there. That would be a real wake-up call for them!

I have been following CafePharma also. The company boards are quite interesting. I hate to think that the sales reps. who post there are truely representative of the people who truely "educate" way too many doctors, relative to their product. Spooky dudes.

I suspect that the new product will be a time released version of the present Lyrica. I wonder if a time released version would be less proned to the side effects. The outsource companies that make the generics would be smart to make a lower dose "entry level" pill. I suspect some patients might not have as much trouble if they could start at a lower level and slowly work up to their theraputic level. I have only taken 75 mg twice a day since it came out and had problems for the first few months. I hung in there only because it was giving me some additional relief.

I wonder what dx some of the doctors have been using to justify writing it.

[mrsD]

The timed release gabapentin is very potent, and a lower dose.
It has warnings to this effect even.

I would assume Lyrica would be similar.

[Spiney95]

Originally Posted by mrsD

The timed release gabapentin is very potent, and a lower dose.
It has warnings to this effect even.

I would assume Lyrica would be similar.

One can only hope but I am certain you are correct. It was on one of the company boards where I read that unless they were dealing with a med that had common pediatric use, they didn't like to make a true, low, entry level dose as the patients are not on it for long and therefore there is little money in it. It seems like common sense to me that they would want to make it easier for the patient to start out low and find a therputic dose. As it is with too many meds., many patients feel like they have been hit by a bomb starting out and have it discontinued. There's no money in that either. Of course, they have crunched the numbers and know how many patients they can lose to preventable side effects and still make a tidy profit. Sigh.

[mrsD]

Yes, the Horizant form of extended release gabapentin, is more bioavailable at lower doses, so less is needed each day.

Since Lyrica is taken 3 times a day, normally, an extended release form, may also be more efficient leading to new dosing requirements.

There is a warning that comes with Horizant that dosing with it should be DIFFERENT from other gabapentin products.
In fact I saw a paper a while ago where the FDA was quoted as recommending a lower starting dose than 300mg. But now I cannot find that. The concern is drowsiness while driving or using machinery.

[Dr. Smith]

Originally Posted by mrsD

Yes, the Horizant form of extended release gabapentin, is more bioavailable at lower doses, so less is needed each day.

Since Lyrica is taken 3 times a day, normally, an extended release form, may also be more efficient leading to new dosing requirements.

I can't tell if there's still some confusion about this. From our previous discussion about the 2 new(er) forms of gabapentin:
http://neurotalk.psychcentral.com/sh...light=horizant

Gabapentin enacarbil is a form of gabapentin with increased bioavailability with both immediate and extended (sustained) release formulations.
http://jcp.sagepub.com/content/48/12/1378

Horizant® is an extended (sustained) release form of gabapentin enacarbil.
http://www.medilexicon.com/drugs/horizant.php

[Emphasis modified]

AFAIK, it's the increased bioavailability that makes Horizant more efficient leading to new dosing requirements - not just the extended release factor.
(Admittedly pedantic, but technically correct.)

So I would think it stands to reason that more efficiency in dosing Lyrica/pregabalin may also require a more bioavailable form (I haven't seen the CafePharma thread, so I don't know if this was covered/mentioned). The patent clocks would likely be restarted in either event.

If this is all they've got in the way of next gen neuropathic pain medication (gabapentin--> pregabalin--> ???), I'm disappointed; it seems more like a stalling tactic. (Good Grief, I've succumbed to Internet-Age Immediate Gratification Impatience! )

Doc