Why urine, not liver, sets 150 mg
About 90 percent of a dose is recovered in urine as unchanged pregabalin. Mean renal clearance in young healthy people sat near 67 to 80.9 mL/min. Elimination tracks creatinine clearance almost in proportion.
CYP stories from other pain tablets do not rescue this one. If the creatinine climbed, the day shrank. Recalculate.
Ceilings shrink on the same table
The 300, 450, and 600 columns shrink in lockstep. A fibromyalgia dream of 450 mg/day is not available on a 40 mL/min clearance the way it is at 80. Recalculate first. Pain second. Ceiling scan.
Older adults often look like a renal problem until proven otherwise. Do not wait for sock marks to argue. Edema scan.
The hemodialysis extra is labelled
A supplemental dose after a four-hour run is on the table. The size depends on the daily regimen you were already on. Clinic math, not a group-chat extra 150.
Skip-a-run weekends still need the prescribed day. Do not double the next capsule because dialysis was delayed.
How a 150 mg start walks the columns
CrCl at or above 60 mL/min: 150 mg/day in two or three doses. 30-60: 75 mg/day in two or three doses. 15-30: 25-50 mg/day once or twice. Below 15: 25 mg once daily.
The label's own example: a PHN start of 150 mg/day in ordinary kidneys becomes 75 mg/day split at CrCl 50 mL/min. People who keep swallowing the 150 capsule at that clearance are on a different drug-day than the table.
EGFR on the portal is not the PI's column
The PI example uses Cockcroft-Gault creatinine clearance. A portal eGFR of 48 is a clue, not the exact column. Ask which number the prescriber used before you keep a 150 mg BID plan.
150 mg twice daily would be a 300 mg day. In reduced kidneys that is a different exposure than a 75 mg/day rewrite.
Kidney tag after the columns
Unchanged drug. Columns rewrite 150. Hemodialysis extra after four hours. Yuki Tanaka tags the table after section 2.7.
Written line still required: order scan. Schedule V still applies at 25 mg/day.