Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Pregabalin (Lyrica) and milnacipran (Savella) are both medications used to treat fibromyalgia in adults. However, they belong to different medication classes and have important differences. Pregabalin is an antiepileptic medication that also treats nerve pain from conditions like diabetes and shingles and can be used with other medications to prevent seizures. It is available as a capsule and oral solution and is typically taken 2 or 3 times a day. Common side effects include dizziness and drowsiness. Milnacipran, on the other hand, is a serotonin and norepinephrine reuptake inhibitor (SNRI) specifically approved for fibromyalgia. The usual dosage is 50 mg to 100 mg twice daily, after completing the starting dosages. Unlike pregabalin, milnacipran is not a controlled substance and does not have a generic version available. Common milnacipran side effects include nausea, headache, and dizziness. While both medications can cause dizziness, pregabalin may lead to weight gain, whereas milnacipran does not typically cause weight gain and may even lead to slight weight loss. Additionally, milnacipran carries a risk of serotonin syndrome and can affect blood pressure and heart rate, which are not concerns with pregabalin.
Pregabalin (Lyrica)
Savella (milnacipran)
Pregabalin (Lyrica)
Savella (milnacipran)
Summary of Lyrica vs. Savella
Summary for Antiepileptic
Prescription only
Pregabalin (Lyrica) helps treat nerve pain and fibromyalgia in adults. It can also be taken with other medications to help treat certain seizures in people 1 month and older. Pregabalin (Lyrica) comes as a capsule and oral solution in both brand-name and generic versions. The dosage depends on what condition you're treating, but it's usually taken by mouth 2 or 3 times a day. Common side effects include feeling dizzy and drowsy. This medication is a controlled substance and has interactions, like with alcohol and benzodiazepines.
Summary for Serotonin and norepinephrine reuptake inhibitor (SNRI)
Prescription only
Savella (milnacipran) is FDA approved to manage fibromyalgia in adults. It belongs to the drug class called serotonin and norepinephrine reuptake inhibitors (SNRIs). Savella (milnacipran) is a tablet that's taken by mouth twice a day. You'll usually follow a dosing schedule for the first few days to reach the right dose for you. Side effects can include nausea, constipation, headache, and dizziness. As of January 2025, Savella (milnacipran) is only available as a brand-name medication. There's no generic version yet.