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.
