Pharmacokinetic evaluation of the necessity of supplemental pregabalin administration after hemodialysis in two cases.

Abstract

The supplemental pregabalin (PGN) doses after hemodialysis (HD) were described on the basis of simulation data of administration at 6 hours prior to starting HD on drug PGN package inserts. However, it is unclear whether supplemental PGN is necessary after HD. Therefore, we investigated the pharmacokinetics of PGN by measuring the plasma concentration in two HD patients. The PGN doses were 50 mg/day. Plasma PGN concentrations were measured at seven points from the day of HD to the next non-HD day.The true removal rates during HD were 55.6% and 37.8%, the dialysis PGN clearance was 109.5mL/min and 74.6mL/min, and the half-life of PGN was 35 hours and 89 hours on non-HD day for the two cases, respectively. The contribution ratio of HD in PGN removal were only 9.6%, and 4.9%, as compared with normal renal function. The ratios of the estimated AUC on the HD day (eAUC_HD) versus that on the non-HD day (eAUC_nonHD) were 85.3% and 85.7% for the two cases, respectively.The half-life of PGN on non-HD day was markedly extended compared to that in healthy subjects; eAUC_HD against eAUC_nonHD differed by only 15%, and the contribution ratio of HD in PGN removal was low.Our data indicate that supplemental PGN administration might not be necessary following HD if PGN dosage for a creatinine clearance < 15mL/min is administered after HD closure.