Detection Times of Pregabalin in Urine After Illicit Use: When Should a Positive Specimen Be Considered a New Intake?

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Background:Pregabalin has an abuse potential and is occasionally used as a recreational drug. To draw the right conclusions regarding new intake of pregabalin in situations of repeated urinary drug testing, the knowledge of its disappearance rate in urine is essential.Methods:One healthy male volunteer took a single oral dose of pregabalin at 2 occasions, first 75 mg and thereafter 150 mg. All urine was collected in 8-hour portions for 5 days and analyzed for pregabalin. A systematic search for literature describing concentrations of pregabalin in urine was performed, and the results from these studies were interpreted on the basis of the findings from the healthy volunteer.Results:In the healthy volunteer, specimens remained positive for 56 hours after intake of 75 mg and for 64 hours after intake of 150 mg. Urinary elimination half-lives based upon creatinine-normalized concentrations were 5.7–5.9 hours. The systematic literature search revealed only 1 article describing urinary concentrations of pregabalin. In that study, including 4799 urinary samples, the median concentration was not higher than the initial concentration found in the healthy volunteer. By applying a urinary elimination half-life of 6 hours on that material, at least 50% would be expected to have negative urine specimens within 3 days and a total of 5 days would be needed to achieve negative urine specimens in the subject with the maximum urinary concentration measured.Conclusion:In subjects with normal renal function, it seems highly unlikely that a urine specimen should remain positive for pregabalin for more than 5–6 days after intake.

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