(From ISMP Medication Safety Alert, 6/1/06; reprinted with permission)
A pharmacist alerted us to a potential for error when referencing a dosing chart in the package insert for LYRICA (pregabalin), a new drug used to treat neuropathic pain from diabetic peripheral neuropathy and post-herpatic neuralgia. A table of dose adjustments lists creatinine clearance levels with corresponding daily doses of the drug. However, the dose regimen is listed as BID, TID, or QD.
Unfortunately, the manufacturer intends BID to mean that the total daily dose should be divided into two doses, while most would expect its meaning to suggest twice-a-day dosing. Likewise, the manufacturer uses TID to mean dividing the total dose into three doses daily, while most expect it to mean to give the expressed dose three times daily. While we certainly do not condone the use of the error-prone abbreviation QD, at least the manufacturer didn’t alter its typical meaning: daily. If you are using, or plan to use LYRICA make sure your health care-provider gives you clear dosing instructions.