Clasica Uses

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What is Clasica?

Clasica (Clasica) is an anti-epileptic drug, also called an anticonvulsant. Clasica works by slowing down nerve impulses in the brain and affects chemicals that send pain signals across the nervous system.

Clasica is a prescription medicine used to treat pain caused by damaged nerves in people with diabetes (diabetic neuropathy). Clasica is also used to treat pain caused by damaged nerves (neuropathic pain) that follows healing of shingles (herpes zoster). This condition is called post-herpetic neuralgia.

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It is not known if Clasica is effective when used for the treatment of fibromyalgia, or when taken with other seizure medicines for adults with partial onset seizures.

Clasica is supplied as extended-release tablets in the following strengths: 82.5 mg, 165 mg, and 330 mg.

Clasica indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Neuropathic Pain: Clasica is indicated for the treatment of neuropathic pain in adults, including neuropathic pain associated with spinal cord injury.

Epilepsy: Clasica is indicated as adjunctive therapy in adults with partial seizures, with or without secondary generalization.

Generalized Anxiety Disorder: Clasica is indicated for the treatment of Generalized Anxiety Disorder (GAD) in adults.

Fibromyalgia: Clasica is indicated for the management of fibromyalgia.

How should I use Clasica?

Use Clasica solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Clasica solution.

Uses of Clasica in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Fibromyalgia (immediate release only): Management of fibromyalgia

Neuropathic pain associated with diabetic peripheral neuropathy (immediate release and extended release): Management of neuropathic pain associated with diabetic peripheral neuropathy

Neuropathic pain associated with spinal cord injury (immediate release only): Management of neuropathic pain associated with spinal cord injury

Postherpetic neuralgia (immediate release and extended release): Management of postherpetic neuralgia

Seizures, focal (partial) onset (immediate release only): Adjunctive therapy in patients ≥1 month of age with focal onset (partial-onset) seizures

Off Label Uses

Cough, chronic refractory

Data from a limited number of patients in a controlled trial suggest that Clasica in combination with speech pathology therapy may be beneficial for the treatment of refractory chronic cough.

Based on the American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) position statement on menopause, the Endocrine Society guideline on the treatment of symptoms of menopause, and the North American Menopause Society (NAMS) position statement on nonhormonal management of menopause-associated vasomotor symptoms, Clasica is an effective and recommended alternative for the management of vasomotor symptoms associated with menopause in patients with contraindications to hormonal therapy or who prefer not to use hormonal therapy.

Clasica description

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Each capsule contains the following inactive ingredients: Mannitol, maize starch and talc.

Clasica is described chemically as (S)-3-(aminomethyl)-5-methylhexanoic acid. The molecular formula is C8H17NO2 and the molecular weight is 159.23.

Clasica is a white to off-white, crystalline solid with a pKa1 of 4.2 and a pKa2 of 10.6. It is freely soluble in water and both basic and acidic aqueous solutions. The log of the partition coefficient (n-octanol/0.05 M phosphate buffer) at pH 7.4 is -1.35.

Clasica dosage

The dose range is 150 to 600 mg per day given in either two or three divided doses.

Epilepsy: Clasica treatment can be started with a dose of 150 mg per day given as two or three divided doses. Based on individual patient response and tolerability, the dose may be increased to 300 mg per day after 1 week. The maximum dose of 600 mg per day may be achieved after an additional week.

Generalised Anxiety Disorder: The dose range is 150 to 600 mg per day given as two or three divided doses. The need for treatment should be reassessed regularly.

Clasica treatment can be started with a dose of 150 mg per day. Based on individual patient response and tolerability, the dose may be increased to 300 mg per day after 1 week. Following an additional week, the dose may be increased to 450 mg per day. The maximum dose of 600 mg per day may be achieved after an additional week.

Discontinuation of Clasica: In accordance with current clinical practice, if Clasica has to be discontinued, it is recommended this should be done gradually over a minimum of 1 week independent of the indication.

Patients with Renal Impairment: Clasica is eliminated from the systemic circulation primarily by renal excretion as unchanged drug. As Clasica clearance is directly proportional to creatinine clearance, dose reduction in patients with compromised renal function must be individualised according to creatinine clearance (CrCl), as indicated in Table 1 determined using the following formula.

Clasica is removed effectively from plasma by haemodialysis (50% of drug in 4 hours). For patients receiving haemodialysis, the Clasica daily dose should be adjusted based on renal function. In addition to the daily dose, a supplementary dose should be given immediately following every 4-hour haemodialysis treatment.

Patients with Hepatic Impairment: No dose adjustment is required for patients with hepatic impairment.

Children: The safety and efficacy of Clasica Sandoz in children below the age of 12 years and in adolescents (12-17 years of age) have not been established. No data are available.

Elderly (over 65 years of age): Elderly patients may require a dose reduction of Clasica due to a decreased renal function.

Administration: Clasica Sandoz may be taken with or without food.

Clasica Sandoz is for oral use only.

Clasica interactions

See also:
What other drugs will affect Clasica?

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Since Clasica is predominantly excreted unchanged in the urine, undergoes negligible metabolism in humans (less than 2% of a dose recovered in urine as metabolites), and does not bind to plasma proteins, its pharmacokinetics are unlikely to be affected by other agents through metabolic interactions or protein binding displacement. In vitro and in vivo studies showed that Clasica is unlikely to be involved in significant pharmacokinetic drug interactions. Specifically, there are no pharmacokinetic interactions between Clasica and the following antiepileptic drugs: carbamazepine, valproic acid, lamotrigine, phenytoin, phenobarbital, and topiramate. Important pharmacokinetic interactions would also not be expected to occur between Clasica and commonly used antiepileptic drugs.

Pharmacodynamics

Multiple oral doses of Clasica were co-administered with oxycodone, lorazepam, or ethanol. Although no pharmacokinetic interactions were seen, additive effects on cognitive and gross motor functioning were seen when Clasica was co-administered with these drugs. No clinically important effects on respiration were seen.

Drug Abuse And Dependence

Controlled Substance

Clasica is a Schedule V controlled substance.

Clasica is not known to be active at receptor sites associated with drugs of abuse. As with any CNS active drug, carefully evaluate patients for history of drug abuse and observe them for signs of Clasica misuse or abuse (e.g., development of tolerance, dose escalation, drug-seeking behavior).

Abuse

In a study of recreational users (N=15) of sedative/hypnotic drugs, including alcohol, Clasica (450 mg, single dose) received subjective ratings of “good drug effect,” “high” and “liking” to a degree that was similar to diazepam (30 mg, single dose). In controlled clinical studies in over 5500 patients, 4 % of Clasica-treated patients and 1 % of placebo-treated patients overall reported euphoria as an adverse reaction, though in some patient populations studied, this reporting rate was higher and ranged from 1 to 12%.

Dependence

In clinical studies, following abrupt or rapid discontinuation of Clasica, some patients reported symptoms including insomnia, nausea, headache or diarrhea, consistent with physical dependence. In the postmarketing experience, in addition to these reported symptoms there have also been reported cases of anxiety and hyperhidrosis.

Clasica side effects

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What are the possible side effects of Clasica?

The Clasica clinical programme involved over 8900 patients who were exposed to Clasica, of whom over 5600 were in double-blind placebo controlled trials. The most commonly reported adverse reactions were dizziness and somnolence. Adverse reactions were usually mild to moderate in intensity. In all controlled studies, the discontinuation rate due to adverse reactions was 12% for patients receiving Clasica and 5% for patients receiving placebo. The most common adverse reactions resulting in discontinuation from Clasica treatment groups were dizziness and somnolence.

In Table 2, all adverse reactions which occurred at an incidence greater than placebo and in more than one patient, are listed by class and frequency: Very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<l/10,000), not known (cannot be estimated from the available data).

Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness.

The adverse reactions listed may also be associated with the underlying disease and/or concomitant medicinal products.

In the treatment of central neuropathic pain due to spinal cord injury the incidence of adverse reactions in general, CNS adverse reactions and especially somnolence was increased.

Additional reactions reported from post-marketing experience are included as Frequency not known in italics in the table below.

After discontinuation of short-term and long-term treatment with Clasica withdrawal symptoms have been observed in some patients. The following reactions have been mentioned: Insomnia, headache, nausea, anxiety, diarrhoea, flu syndrome, convulsions, nervousness, depression, pain, hyperhidrosis and dizziness, suggestive of physical dependence. The patient should be informed about this at the start of the treatment.

Concerning discontinuation of long-term treatment of Clasica, data suggest that the incidence and severity of withdrawal symptoms may be dose-related.

Clasica contraindications

See also:
What is the most important information I should know about Clasica?

You may have thoughts about suicide while taking this medication. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, depression, anxiety, insomnia, or if you feel agitated, hostile, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

If you are taking Clasica to prevent seizures, keep taking the medication even if you feel fine.

Do not stop using Clasica without first talking to your doctor, even if you feel fine. You may have increased seizures or withdrawal symptoms such as headache, sleep problems, nausea, and diarrhea. Ask your doctor how to avoid withdrawal symptoms when you stop using Clasica.

Do not change your dose of Clasica without your doctor's advice. Tell your doctor if the medication does not seem to work as well in treating your condition.

Wear a medical alert tag or carry an ID card stating that you take Clasica. Any medical care provider who treats you should know that you take seizure medication.



Active ingredient matches for Clasica:

Pregabalin in Argentina.


List of Clasica substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
75 mg x 10's (Cubit)
Cuprega 75mg SR-TAB / 10 (Cubit)
CUPREGA SR tab 75 mg x 10's (Cubit)
Cuprega 75mg SR-TAB / 10 (Cubit)
Damlin M Capsule (Events Pharmaceuticals Pvt Ltd)$ 0.14
Dcg Max 150mg Tablet SR (Evaxo Pharma)$ 0.23
DCG MAX-SR 150MG TABLET 1 strip / 10 tablets each (Evaxo Pharma)$ 2.26
DCG MAX-SR 75 TABLET 1 strip / 10 tablets each (Evaxo Pharma)$ 1.51
Injectable; Injection; Ketorolac Tromethamine 30 mg (Tecnofarma)
Tablet; Oral; Ketorolac Tromethamine 10 mg (Tecnofarma)
Tablets; Oral; Ketorolac Tromethamine 10 mg (Tecnofarma)
Dom-pregabalin capsule 300 mg (Dominion Pharmacal (Canada))
Dom-pregabalin capsule 150 mg (Dominion Pharmacal (Canada))
Dom-pregabalin capsule 25 mg (Dominion Pharmacal (Canada))
Dom-pregabalin capsule 225 mg (Dominion Pharmacal (Canada))
Dom-pregabalin capsule 50 mg (Dominion Pharmacal (Canada))
Dom-pregabalin capsule 75 mg (Dominion Pharmacal (Canada))
100's (Forgo)$ 16.67
Ecogab Pregabalin 75 mg, mecobalamin750 mg. TAB / 100 (Forgo)$ 16.67
ECOGAB tab 10's (Forgo)$ 1.67
Ecogab Pregabalin 75 mg, mecobalamin750 mg. TAB / 100 (Forgo)$ 16.67
ESVIGA cap 75 mg x 10's (USV)$ 1.30
ESVIGA cap 150 mg x 10's (USV)$ 2.31
EZEGALIN 75MG TABLET SR 1 strip / 10 tablet srs each (Eisai Pharmaceuticals India Pvt Ltd)$ 1.52

References

  1. DailyMed. "PREGABALIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "Pregabalin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "Pregabalin". http://www.drugbank.ca/drugs/DB00230 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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