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    Lyrica

    Drug - Lyrica (Pregabalin)

    June 2012

    Therapeutic area - Neuropathic Pain, Partial Onset Seizures

    Criteria

    PA criteria are limited to FDA approved indications. 

    Prescriptions should be managed within the quantity limits.

    Lyrica Strength Quantity limit/Month
    25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg 90
    300 mg 60

    PA criteria

    Adjunctive therapy for adult patients with partial onset seizures 

    • Approved

    Management of neuropathic pain after spinal cord injury

    • Approved

    Management of neuropathic pain associated with diabetic peripheral neuropathy*

    • Patient has had an adequate trial of gabapentin at adequate dose and duration for diabetic peripheral neuropathy
    • Approved for one fill, if patient has benefit, PA may be extended

    Management of postherpetic neuralgia*

    • Patient has had an adequate trial of gabapentin at adequate dose and duration
    • Approved for one fill, if patient has benefit, PA may be extended

    Fibromyalgia*

    • Patient has had an adequate trial of a tricyclic antidepressant, such as amitriptyline or doxepin1,2
    • Patient has had an adequate trial of gabapentin3
    • Approved for one fill, if patient has benefit, PA may be extended

    *Multiple PA’s for one individual are not allowed, except for patients with a diagnosis of partial onset seizures.

    Lyrica was shown to benefit some patients who had a fibromyalgia pain score ≥ 4 on a scale of 0 to 10. Whereas about 28% of placebo-treated patients had an improvement of ≥30% in pain from baseline, about 35-40% of Lyrica-treated patients had this same degree of improvement.4 Whereas about 17% of placebo-treated patients reported a 50% improvement in pain scores, about 23% of Lyrica-treated patients showed a 50% improvement in pain scores.4 There is a dose-dependent benefit to Lyrica to a maximum of 450 mg.  600 mg did not improve pain scores but increased the incidence of side effects.4

    1  Lawson K. Tricyclic antidepressants and fibromyalgia: what is the mechanism of action? Expert Opin Investig Drugs. 2002;11:1437-45.
    2  Arnold LM. Biology and therapy of fibromyalgia. New Therapies for fibromyalgia. Arthritis Research and Therapy. 2006;8:212. can be found at http://arthritis–research.com/content/8/4/212.
    3  Arnold, LM et al. Gabapentin in the treatment of fibromyalgia; a randomized, double-blind, placebo-controlled multicenter trial. Arthritis Rheum. 2007; 56: 1336-1344.
    4  Lyrica prescribing information. Pfizer Pharmaceuticals. June 2007

    Questions?

    MHCP Provider Call Center 651-431-2700 or 800-366-5411

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