Comparative Pharmacology
Head-to-head clinical analysis: DILANTIN versus PREGABALIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILANTIN versus PREGABALIN.
DILANTIN vs PREGABALIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Phenytoin stabilizes neuronal membranes and decreases seizure activity by increasing efflux or decreasing influx of sodium ions across cell membranes in the motor cortex during generation of nerve impulses. It acts by blocking voltage-dependent sodium channels, thereby inhibiting the spread of seizure activity.
Binds to the alpha2-delta subunit of voltage-gated calcium channels, reducing calcium influx and decreasing release of excitatory neurotransmitters (e.g., glutamate, norepinephrine, substance P).
300–400 mg/day orally in 2–3 divided doses; IV loading dose 15–20 mg/kg at max 50 mg/min, then 300 mg/day IV divided 2–3 times daily.
Initial: 75 mg orally twice daily; may increase to 150 mg twice daily within 1 week; maximum: 600 mg/day in divided doses.
None Documented
None Documented
Clinical Note
moderatePregabalin + Fluticasone propionate
"The therapeutic efficacy of Fluticasone propionate can be increased when used in combination with Pregabalin."
Clinical Note
moderatePregabalin + Haloperidol
"The therapeutic efficacy of Haloperidol can be increased when used in combination with Pregabalin."
Clinical Note
moderatePregabalin + Erythromycin
"The metabolism of Erythromycin can be decreased when combined with Pregabalin."
Clinical Note
moderatePregabalin + Fluconazole
Average 22 hours (range 7-42 hours) in adults. Dose-dependent; increases with higher concentrations due to saturable metabolism. In neonates: 10-15 hours. In chronic use, half-life may increase.
Terminal elimination half-life is approximately 6.3 hours. In patients with renal impairment, half-life is prolonged (up to 48 hours in anuria). Requires dose adjustment based on creatinine clearance.
Primarily hepatic metabolism to inactive metabolites (p-hydroxyphenyltoin and glucuronide conjugate). Less than 5% excreted unchanged in urine. Fecal excretion minimal (<2%).
Primarily renal excretion as unchanged drug (92-99% of dose). Approximately 0.1% is metabolized. No biliary or fecal elimination of significance.
Category C
Category A/B
Anticonvulsant
Anticonvulsant
"The serum concentration of Fluconazole can be increased when it is combined with Pregabalin."