Reviewed clinical summary · Source-linked · Educational use only

Is Once-Daily Pregabalin Safe and Effective for Diabetic Nerve Pain?

Clinical Bottom Line

Summary: In patients with diabetic peripheral neuropathy (DPN), once-daily prolonged-release (PR) pregabalin significantly improved pain management compared to placebo and was comparable to immediate-release (IR) pregabalin, though it was associated with common side effects like dizziness and somnolence. PICO Description Population Patients…

Summary: In patients with diabetic peripheral neuropathy (DPN), once-daily prolonged-release (PR) pregabalin significantly improved pain management compared to placebo and was comparable to immediate-release (IR) pregabalin, though it was associated with common side effects like dizziness and somnolence.
PICO Description
Population Patients with diabetic peripheral neuropathy experiencing moderate to severe pain.
Intervention Once-daily prolonged-release pregabalin (150–600 mg/day).
Comparison Placebo and immediate-release pregabalin (thrice-daily doses of 150–600 mg/day).
Outcome Pregabalin PR had comparable efficacy to pregabalin IR in managing pain and significantly improved outcomes compared to placebo. Common side effects included dizziness and somnolence.
RCT Pain Pract · 2025

Once-daily PR pregabalin for diabetic neuropathy pain

RCT · diabetic peripheral neuropathy · 13 weeks

Trial design
DPN, moderate-severe pain Enrolled & assessed RANDOMISED 1:1:1 Pregabalin PR Once-daily 150-600 mg n = 151 Placebo Once daily n = 151 Change in mean weekly pain score (baseline to wk 13)
Change from baseline — both arms
weekly pain score Baseline Week 13 -3.43 vs -3.04 Pregabalin PR Placebo
Pain score change, PR
-3.43
LSM, FAS
Pain score change, placebo
-3.04
LSM, FAS
PR vs placebo
p=0.0158
superior
PR vs IR difference
0.06
95% CI -0.28, 0.41
⬡ Bottom Line

Once-daily prolonged-release pregabalin cut weekly pain scores more than placebo and was non-inferior to thrice-daily immediate-release pregabalin in diabetic peripheral neuropathy. Dizziness and somnolence were the common adverse effects.

Source: Shilpi Dhawan, et al. “Efficacy and Safety of Once-Daily Prolonged-Release Pregabalin for the Treatment of Patients With Diabetic Peripheral Neuropathy: A Randomized, Double-Blind, Active, and Placebo-Controlled Trial.” Read article here.

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