Pregabalin Prescribing Guidelines

Introduction to Pregabalin

• The Federation of State Medical Boards recommends patient-provider agreements (PPAs) when patients with chronic pain are prescribed opioid analgesics, not for non-opioid medications like pregabalin 1, 2
• Pregabalin is classified as an adjuvant analgesic, not an opioid, and is used to enhance pain relief and reduce opioid requirements, as stated by the National Comprehensive Cancer Network 3, 4

Clinical Monitoring and Pain Management Contracts

• The American College of Emergency Physicians states that pain contracts/treatment agreements should be honored for patients undergoing chronic opioid therapy, with no mention of such requirements for adjuvant medications like pregabalin 5
• Standard medication monitoring for pregabalin includes periodic assessment of efficacy and tolerability, as recommended by the National Comprehensive Cancer Network 3, 4
• Checking prescription drug monitoring programs (PDMPs) is recommended when clinically indicated, particularly if aberrant behavior is suspected, as suggested by the American College of Emergency Physicians 5

Opioid Prescribing Guidelines

• Pain management contracts should be implemented when prescribing opioid analgesics for chronic pain management, regardless of whether adjuvant medications like pregabalin are co-prescribed, as recommended by the Clinical Infectious Diseases journal 1, 2
• Patients already established on opioid therapy with existing pain contracts from their primary providers should have these contracts honored in acute care settings, as stated by the American College of Emergency Physicians 5