Titration to an effective dose is often unattainable3
Gabapentin
Pregabalin
Only 14%
of gabapentin patients reach the minimally effective dose of 1800 mg/day due to dose-limiting side effects3-10*
of gabapentin patients reach the minimally effective dose of 1800 mg/day due to dose-limiting side effects3-10*
Takes 10 weeks, on average3
Supporting evidence3
Study Design
- A retrospective analysis of a claims database from a national US health plan
- Covered 26.9 million adults during the study period
- Study population: health plan members with PHN initiating treatment with gabapentin or pregabalin
- Claims data available for 12 months after initiation
Results
- Identified 1645 patients with PHN receiving gabapentin (826 mg mean daily dose) or pregabalin (187 mg mean daily dose)
Gabapentin
Took 10 weeks, on average
14%
of patients treated
with gabapentin
reached 1800 mg/day
- Of the 37% who added a therapy to pregabalin, 57% added an opioid
Pregabalin
Took 9.2 weeks, on average
27%
of patients treated with pregabalin reached ≥300 mg/day
- Of the 31% who added a therapy to pregabalin, 58% added an opioid
PHN = post-herpetic neuralgia.
Patient function and quality of life can be negatively impacted when pain relief is not enough
Only 27%
of pregabalin patients reach the minimally effective dose of ≥300 mg/day due to dose-limiting side effects3,4,9*
of pregabalin patients reach the minimally effective dose of ≥300 mg/day due to dose-limiting side effects3,4,9*
Takes 9.2 weeks, on average3
Supporting evidence3
Study Design
- A retrospective analysis of a claims database from a national US health plan
- Covered 26.9 million adults during the study period
- Study population: health plan members with PHN initiating treatment with gabapentin or pregabalin
- Claims data available for 12 months after initiation
Results
- Identified 1645 patients with PHN receiving gabapentin (826 mg mean daily dose) or pregabalin (187 mg mean daily dose)
Gabapentin
Took 10 weeks, on average
14%
of patients treated
with gabapentin
reached 1800 mg/day
- Of the 37% who added a therapy to pregabalin, 57% added an opioid
Pregabalin
Took 9.2 weeks, on average
27%
of patients treated with pregabalin reached ≥300 mg/day
- Of the 31% who added a therapy to pregabalin, 58% added an opioid
PHN = post-herpetic neuralgia.
*The mean daily dose of pregabalin was 187.08 ± 102.88
Of those who added a therapy to pregabalin, 58% added an opioid3
But adding oral analgesics to boost gabapentinoids comes with baggage3,6-7
*1800 mg/day was the minimally effective dose in clinical trials (doses up to 3600 mg/day may be required in some patients).6-7
An 8-week trial
using up to 3 patches daily,
(to ensure adequate
coverage of the painful area)
is recommended to achieve
similar results1
Study design: Phase 3, two-stage
adaptive, randomized, open-label study (N=98) in patients with PHN; chart shows patients treated with pregabalin alone, then in combination with a ZTlido equivalent.1†
adaptive, randomized, open-label study (N=98) in patients with PHN; chart shows patients treated with pregabalin alone, then in combination with a ZTlido equivalent.1†
Study design1
A phase 3, two-stage randomized, open-label study comparing ZTlido* with pregabalin monotherapy in 98 patients with PHN†
Stage 1:
Patients randomized to 4 weeks’ monotherapy with either
- Pregabalin titrated to effect
- All patients received 150 mg/day in week 1 and 300 mg/day in week 2
- At the end of week 2, dose increased to 600 mg/day in
patients with insufficient relief (NRS >4)
- ZTlido: up to 3 patches/day (12 hours on, 12 hours off)
STAGE 2:
- Sufficiently treated with monotherapy (NRS ≤4), continued the same agent for 8 weeks
- Insufficiently treated with monotherapy (NRS >4), received both drugs in combination for 8 weeks
- Results presented from patients insufficiently treated with pregabalin monotherapy
AE=adverse event; NRS=numeric rating scale; PGIC=Patient Global Impression of Change; PHN=post-herpetic neuralgia; QoL=quality of life.
*ZTlido equivalent; "ZTlido equivalent" connotes that study was performed using bioequivalent lidocaine 5% patch.
†Concomitant analgesics not permitted, except rescue acetaminophen (≤2 g/day).
‡11-point NRS (0=no pain to 10=pain as bad as you can imagine).
PHN=post-herpetic neuralgia; SF-MPQ=Short-Form McGill Pain Questionnaire; VAS=visual analog scale.
*SF-MPQ pain intensity was assessed on a VAS of 0 (no pain) to 100 (worst possible pain).
†ZTlido equivalent.
"ZTlido equivalent" connotes that study was performed using bioequivalent lidocaine 5% patch.
*SF-MPQ pain intensity was assessed on a VAS of 0 (no pain) to 100 (worst possible pain).
†ZTlido equivalent.
"ZTlido equivalent" connotes that study was performed using bioequivalent lidocaine 5% patch.
IMPORTANT SAFETY INFORMATION
Side effects of ZTlido include application site reactions such as irritation, erythema, and pruritus. These are not all of the adverse reactions that may occur.
TESTIMONIAL
For an optimal viewing experience, please ensure the video sound is turned on.
Hear what your peers are saying about ZTlido
Ensure adequate coverage of the painful area
When you need more than 1 patch to cover the painful area. ZTlido is indicated for up to 3 patches a day (12 hours on /12 hours off delivers 24 hours of pain control).1,2
Use daily for at least 8 weeks
ZTlido has a dual-effect mechanism of action—peripheral, as a well as central—with continued daily use.11
To get the full therapeutic effect, ZTlido must be used as prescribed every day (not PRN) for at least 8 weeks.
To get the full therapeutic effect, ZTlido must be used as prescribed every day (not PRN) for at least 8 weeks.
Do not allow substitutions
There’s no generic substitution for ZTlido.
ZTlido is not AB-rated/ interchangeable with other lidocaine patches.11
Provide co-pay card and track progress
Give every patient a ZTlido patient brochure, which includes a co-pay card and a symptom/compliance tracker.