Mirogabalin: A Promising New Option for Managing Neuropathic Pain

Mirogabalin: A Promising New Option for Managing Neuropathic Pain

By Naeem Mustafa

PharmaServePK 

December 17, 2025

Neuropathic pain affects millions worldwide, often stemming from conditions like diabetes, shingles, or nerve injuries. Characterized by burning, tingling, or shooting sensations, it can significantly impair quality of life. Traditional treatments like pregabalin and gabapentin have been staples, but a newer gabapentinoid, mirogabalin (brand name Tarlige in some markets, and Miro in Pakistan), is gaining attention for its potential advantages.314efb,2940e1,ca47bf.

Mirogabalin: A Promising New Option for Managing Neuropathic Pain

What is Mirogabalin?

Mirogabalin is a novel medication in the gabapentinoid class, developed by Daiichi Sankyo. It works by binding to the α2δ subunits of voltage-gated calcium channels in the nervous system, reducing the release of excitatory neurotransmitters involved in pain signaling.

Its chemical structure features a unique bicyclic configuration, allowing for stronger and more selective binding compared to older gabapentinoids.64a964,36d66c

Key advantages include:

Higher affinity for the α2δ-1 subunit (linked to pain relief).

Faster dissociation from the α2δ-2 subunit (associated with fewer CNS side effects like dizziness).

This profile may lead to better efficacy and tolerability.

Approved Uses and Availability

First approved in Japan in 2019 under the brand Tarlige for peripheral neuropathic pain, mirogabalin has since expanded to South Korea, Taiwan, and China (including for diabetic peripheral neuropathic pain in 2024). In Pakistan, it's available as Miro tablets (e.g., 5mg and 10mg strengths) from local manufacturers like Nabiqasim, commonly used for nerve pain due to diabetic neuropathy or post-herpetic neuralgia.b802fd,2a7948,a6edc8

It's not yet approved in the US or many Western countries, with development for fibromyalgia discontinued earlier.

How Does It Compare to Pregabalin?

Studies show mirogabalin often provides comparable or superior pain relief with potentially fewer side effects:

Stronger, longer-lasting binding leads to sustained analgesia.

Lower incidence of dizziness and somnolence in some trials.

Effective doses are lower (typically 10-30 mg/day vs. higher for pregabalin).

Clinical trials in Asian populations demonstrated significant reductions in pain scores for diabetic peripheral neuropathic pain (DPNP) and postherpetic neuralgia (PHN). Recent 2025 studies continue to explore its use in various neuropathic conditions.

Dosage and Side Effects

Typical starting dose: 5 mg twice daily, titrated up to 15 mg twice daily.

Adjustments are needed for kidney impairment, as it's primarily renally excreted.

Common side effects (usually mild)

Dizziness

Somnolence

Weight gain

Edema

Always consult a healthcare professional before starting or switching medications.

Mirogabalin represents an advancement in neuropathic pain management, particularly for patients in regions like Pakistan where it's readily available. With growing evidence supporting its efficacy and improved tolerability profile, it could become a preferred alternative to pregabalin for many suffering from chronic nerve pain.

If you're dealing with neuropathic pain, discuss mirogabalin with your doctor to see if it might be right for you.

Disclaimer: This article is for informational purposes only and not medical advice. Consult a qualified healthcare provider for personalized recommendations.

Naeem Mustafa

Pharmacist & Blogger, PharmaServePK