Safety, tolerability, and efficacy of a selective gabapentinoid mirogabalin in neuropathic pain—a topical review
Abstract Gabapentin and pregabalin, known as gabapentinoids, have been used effectively as a monotherapy or in combination with other agents for managing chronic neuropathic pain due to various etiologies. These drugs act via α2δ-1 and α2δ-2 subunits of voltage-gated calcium channels (VGCCs) non-sel...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-10-01
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| Series: | Ain Shams Journal of Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42077-021-00183-1 |
| _version_ | 1819148647379501056 |
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| author | Abhijit Nair Subodh Kamtikar Suresh Seelam |
| author_facet | Abhijit Nair Subodh Kamtikar Suresh Seelam |
| author_sort | Abhijit Nair |
| collection | DOAJ |
| description | Abstract Gabapentin and pregabalin, known as gabapentinoids, have been used effectively as a monotherapy or in combination with other agents for managing chronic neuropathic pain due to various etiologies. These drugs act via α2δ-1 and α2δ-2 subunits of voltage-gated calcium channels (VGCCs) non-selectively. Due to its non-selective action, a certain group of patients reports central nervous system adverse effects like dizziness, drowsiness, somnolence, and cerebellar ataxia. Mirogabalin besylate is an orally administered next-generation gabapentinoid approved for use in diabetic neuropathy and post-herpetic neuralgia. It binds selectively and with greater affinity to the α2δ-1 and α2δ-2 subunits of human VGCCs and thus has lesser central nervous system adverse events making it more tolerable. We reviewed all articles in various categories, published in reputed databases since 2014 where mirogabalin was used to treat chronic neuropathic pain. Case series and open-label studies have demonstrated the safety and efficacy of mirogabalin in cancer pain and lumbar spine disease. Pharmacokinetic/pharmacodynamic studies have cautioned using full dose in patients with renal/hepatic impairment and along with drugs that could lead to adverse effects like sedatives and opioids. Dose up to 30 mg/day when administered as a twice-daily divided dose has been tolerated quite well with adequate pain relief in diabetic neuropathy and post-herpetic neuralgia. Mirogabalin appears to be a safe gabapentinoid in diabetic neuropathy and post-herpetic neuralgia. Further studies need to be conducted to explore the role of mirogabalin in cancer pain, postoperative pain, and neuropathic pain due to various other etiologies. |
| first_indexed | 2024-12-22T13:49:02Z |
| format | Article |
| id | doaj.art-d53389fc90834c318ea9cc0c48a408d4 |
| institution | Directory Open Access Journal |
| issn | 2090-925X |
| language | English |
| last_indexed | 2024-12-22T13:49:02Z |
| publishDate | 2021-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Ain Shams Journal of Anesthesiology |
| spelling | doaj.art-d53389fc90834c318ea9cc0c48a408d42022-12-21T18:23:43ZengSpringerOpenAin Shams Journal of Anesthesiology2090-925X2021-10-011311710.1186/s42077-021-00183-1Safety, tolerability, and efficacy of a selective gabapentinoid mirogabalin in neuropathic pain—a topical reviewAbhijit Nair0Subodh Kamtikar1Suresh Seelam2Department of Anaesthesiology, Ibra Hospital, North Sharqiya Governorate, Ministry of Health-OmanDepartment of Anesthesiology, Bidar Institute of Medical SciencesDepartment of Anesthesiology, Royal HospitalAbstract Gabapentin and pregabalin, known as gabapentinoids, have been used effectively as a monotherapy or in combination with other agents for managing chronic neuropathic pain due to various etiologies. These drugs act via α2δ-1 and α2δ-2 subunits of voltage-gated calcium channels (VGCCs) non-selectively. Due to its non-selective action, a certain group of patients reports central nervous system adverse effects like dizziness, drowsiness, somnolence, and cerebellar ataxia. Mirogabalin besylate is an orally administered next-generation gabapentinoid approved for use in diabetic neuropathy and post-herpetic neuralgia. It binds selectively and with greater affinity to the α2δ-1 and α2δ-2 subunits of human VGCCs and thus has lesser central nervous system adverse events making it more tolerable. We reviewed all articles in various categories, published in reputed databases since 2014 where mirogabalin was used to treat chronic neuropathic pain. Case series and open-label studies have demonstrated the safety and efficacy of mirogabalin in cancer pain and lumbar spine disease. Pharmacokinetic/pharmacodynamic studies have cautioned using full dose in patients with renal/hepatic impairment and along with drugs that could lead to adverse effects like sedatives and opioids. Dose up to 30 mg/day when administered as a twice-daily divided dose has been tolerated quite well with adequate pain relief in diabetic neuropathy and post-herpetic neuralgia. Mirogabalin appears to be a safe gabapentinoid in diabetic neuropathy and post-herpetic neuralgia. Further studies need to be conducted to explore the role of mirogabalin in cancer pain, postoperative pain, and neuropathic pain due to various other etiologies.https://doi.org/10.1186/s42077-021-00183-1MirogabalinNeuropathic painDiabetic neuropathyPost-herpetic neuralgiaChronic pain |
| spellingShingle | Abhijit Nair Subodh Kamtikar Suresh Seelam Safety, tolerability, and efficacy of a selective gabapentinoid mirogabalin in neuropathic pain—a topical review Ain Shams Journal of Anesthesiology Mirogabalin Neuropathic pain Diabetic neuropathy Post-herpetic neuralgia Chronic pain |
| title | Safety, tolerability, and efficacy of a selective gabapentinoid mirogabalin in neuropathic pain—a topical review |
| title_full | Safety, tolerability, and efficacy of a selective gabapentinoid mirogabalin in neuropathic pain—a topical review |
| title_fullStr | Safety, tolerability, and efficacy of a selective gabapentinoid mirogabalin in neuropathic pain—a topical review |
| title_full_unstemmed | Safety, tolerability, and efficacy of a selective gabapentinoid mirogabalin in neuropathic pain—a topical review |
| title_short | Safety, tolerability, and efficacy of a selective gabapentinoid mirogabalin in neuropathic pain—a topical review |
| title_sort | safety tolerability and efficacy of a selective gabapentinoid mirogabalin in neuropathic pain a topical review |
| topic | Mirogabalin Neuropathic pain Diabetic neuropathy Post-herpetic neuralgia Chronic pain |
| url | https://doi.org/10.1186/s42077-021-00183-1 |
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