pregabalin
Pregabalin (Lyrica) treats pain caused by nerve damage and fibromyalgia in adults. It can be used with other medications to prevent seizures for both adults and children. Pregabalin (Lyrica) is taken by mouth, typically 2 or 3 times a day. It's available as a capsule and oral solution. Some of the more common side effects of this medication include dizziness and drowsiness.
What is Pregabalin (Lyrica)?
What is Pregabalin (Lyrica) used for?
Nerve pain from diabetes (diabetic peripheral neuropathy), shingles (postherpetic neuralgia), or spinal cord injury
Fibromyalgia
How Pregabalin (Lyrica) works
Pregabalin (Lyrica) is an anticonvulsant. While the exact way it works to treat nerve pain and seizures isn't well-understood, it's thought to lower certain chemicals in the brain to relieve pain and prevent seizures.
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What are the risks and warnings for Pregabalin (Lyrica)?
Pregabalin (Lyrica) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Allergic reactions and severe swelling
Risk factors: History of unusual swelling | Taking other medications that can cause swelling
Although rare, angioedema (swelling of the face, tongue, neck, and/or other organs) can happen at any time when taking pregabalin (Lyrica). Sometimes, these reactions can be life-threatening because they affect your breathing. If you do experience a reaction, your provider will most likely ask you to stop taking pregabalin (Lyrica) and try different medication instead. Get medical help right away if you develop any head or neck swelling, hives, red skin, blisters, or trouble breathing.
Suicidal thoughts and behavior
Risk factors: Taking anti-seizure medications | History of depression
Like other anti-seizure medications, pregabalin (Lyrica) can
raise the risk of suicidal thoughts or behavior. This is rare, but can happen as early as 1 week after starting the medication. Tell your provider about new or worsening symptoms of depression or unusual changes in mood or behavior right away.
Difficulty driving and concentrating
Risk factors: Drinking alcohol | Taking other medications that cause drowsiness
Taking pregabalin (Lyrica) can make you feel sleepy and affect your concentration and focus. These side effects tend to be higher when starting the medication or when taking higher doses. Avoid activities that require you to be alert, like driving or operating machinery, until you know how the medication affects you.
Breathing problems
Risk factors: History of breathing problems | Taking pregabalin (Lyrica) with CNS depressants
It's best to avoid taking pregabalin (Lyrica) with other medications that can slow your breathing, such as opioid pain medications. Taking them together can lead to life-threatening breathing problems. If you're taking another medication that can slow breathing, your provider might prescribe you a lower dose of pregabalin (Lyrica). If you experience difficulty breathing, get medical help right away.
Swelling in the limbs and weight gain
Risk factors: Taking pregabalin (Lyrica) with certain diabetes medications
Pregabalin (Lyrica) can cause swelling of the limbs, especially if you take certain diabetes medications, such as pioglitazone (Actos). Tell your provider if you have a history of heart problems before starting this medication since extra fluid can make conditions like heart failure worse. If you have a lot of swelling, contact your provider.
Additionally, pregabalin (Lyrica) can commonly cause weight gain. Sometimes, the weight gain is related to the swelling from extra fluids, but this isn't the case for everyone. Your risk of weight gain is higher if you're taking a higher dose of pregabalin (Lyrica) for a longer period of time. Talk to your provider about ways to keep your weight healthy.
Withdrawal symptoms and risk of seizures
Risk factors: Stopping pregabalin (Lyrica) suddenly
Don't suddenly stop taking pregabalin (Lyrica) without first talking with your provider. Doing so can lead to symptoms like nausea, headache, trouble sleeping, sweating, and diarrhea. In addition, if you've been taking pregabalin (Lyrica) to control seizures, stopping it suddenly can cause more seizures. If you want to stop taking this medication, let your provider know. They'll help you lower your dose slowly (over at least one week) before stopping completely.
Possible risk of bleeds (from low platelet levels)
In clinical studies, some people taking pregabalin (Lyrica) had a lower amount of platelets (cells in your blood that help your blood clot). Typically, people who have low platelet levels are at a higher risk for bleeds. But data from clinical trials show that wasn't a higher number of bleeding events from taking pregabalin (Lyrica). To be safe, if you notice blood in your urine or stool, easy bruising, or bleeding that takes longer to stop, let your provider know. They can check your platelet count with a blood test to make sure it's within a safe range.
Possible risk of muscle breakdown
Though rare, pregabalin (Lyrica) might raise your risk for a condition called rhabdomyolysis, which is when your muscles break down. Contact your provider if you notice unexplained muscle pain, tenderness, or weakness.
What are the side effects of Pregabalin (Lyrica)?
Common Side Effects
- Dizziness (8-29%)
- Drowsiness (4-16%)
- Swelling of hands, feet, arms, or legs (4-12%)
- Dry mouth (2-7%)
- Weight gain (4-6%)
Other Side Effects
- Weakness
- Constipation
- Accidental injury
- Poor coordination or movement
- Blurry or abnormal vision
- Difficulty paying attention or concentrating
Serious Side Effects
- Angioedema: swelling in the face, lips, tongue, throat, hands, or feet, trouble breathing
- Severe allergic reaction: hives, trouble breathing, swelling of the face, lips, tongue, or throat
- Suicidal thoughts or behaviors
- Severe drowsiness
- Breathing problems
Source: DailyMed
More on Pregabalin (Lyrica) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching, hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- Blurry vision
- Thoughts of suicide or self-harm, worsening mood, feelings of depression
- Trouble breathing
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Dizziness
- Drowsiness
- Dry mouth
- Nausea
- Swelling of the ankles, feet, hands
- Vomiting
- Weight gain
Pros and cons of Pregabalin (Lyrica)
Pros
Works well to relieve nerve pain caused by diabetes, shingles, and spinal cord injuries
Available in a capsule and oral solution
Used in combination with other anti-seizure drugs to treat partial-onset seizures
Available as a lower-cost generic
Cons
Can cause dizziness and drowsiness
Must avoid drinking alcohol
Not recommended for breastfeeding females
Can cause weight gain
Pharmacist tips for Pregabalin (Lyrica)
You can take pregabalin (Lyrica) with or without food. Food won't affect how well this medication works for you.
If you're taking pregabalin (Lyrica) oral solution, make sure to use the measuring device provided to you at the pharmacy. Don't use household spoons because this could cause you to take or give the wrong amount of medication.
Pregabalin (Lyrica) can cause dizziness, drowsiness, and blurry vision, so don't drive or do anything that requires concentration until you know how this medication affects you.
Mixing pregabalin (Lyrica) with alcohol or other sedating medications (e.g., opioids, benzodiazepines, muscle relaxants) can make you very drowsy, affect your ability to react quickly, and slow your breathing. Tell your provider and pharmacist about all of your medications so they can check for potentially dangerous interactions.
Talk to your healthcare provider if you want to stop taking pregabalin (Lyrica), especially if you're using it to prevent seizures. You'll need to lower your dose slowly over time to avoid any unwanted side effects, such as nausea, headache, trouble sleeping, and seizures.
Pregabalin (Lyrica) can cause vision changes. Make sure to see your eye provider for your annual eye exam, and tell your provider if you notice any changes in your vision.
More on Pregabalin (Lyrica) tips
Frequently asked questions about Pregabalin (Lyrica)
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Pregabalin (Lyrica) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 473ml of 20mg/ml | 1 bottle | $1206.95 | $1206.95 |
Typical dosing for Pregabalin (Lyrica)
The dose will depend on why you're taking pregabalin (Lyrica). You'll typically start at a lower dose, and after 1 week your provider might raise your dose if needed.
Adults
Nerve pain from diabetes: The typical starting dose is 50 mg by mouth 3 times a day.
Nerve pain from shingles: The typical starting dose is 50 mg by mouth 3 times a day or 75 mg by mouth 2 times a day.
Nerve pain from spinal cord injury or fibromyalgia: The typical starting dose is 75 mg by mouth 2 times a day.
Partial-onset seizures (ages 17 years and older): The typical starting dose is 150 mg by mouth, split into 2 or 3 doses and taken throughout the day.
Children (ages 1 month and older)
Partial-onset seizures (brand name Lyrica only): Your child's provider will calculate the dose based on your child's body weight. The typical starting dose ranges from 2.5 mg/kg to 3.5 mg/kg by mouth daily, split into 2 or 3 doses and throughout the day.
Your dose might differ if you have kidney problems.
More on Pregabalin (Lyrica) dosage forms
How much does Pregabalin (Lyrica) cost?
What are alternatives to Pregabalin (Lyrica)?
Nerve pain from diabetes (diabetic peripheral neuropathy), shingles (postherpetic neuralgia), or spinal cord injury
Fibromyalgia
Nerve pain from shingles in adults
Add on treatment for partial (focal) seizures in people age 3 years and older
Nerve pain caused by shingles - 5% and 1.8% patches (by prescription only)
Temporary relief of minor pain - 4% patches (OTC)
What is the latest news about Pregabalin (Lyrica)?
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References
Best studies we foundAlembic Pharmaceuticals Limited. (2023). PREGABALIN capsule [package insert]. DailyMed.
Boomershine, C.S. (2010). Pregabalin for the management of fibromyalgia syndrome. Journal of Pain Research.
Cho, Y. W., et al. (2014). Effects of Pregabalin in Patients with Hypnotic-Dependent Insomnia. Journal of Clinical Sleep Medicine.
Derry, S., et al. (2019). Pregabalin for neuropathic pain in adults. The Cochrane Database of Systematic Reviews.
Kiriakopoulos, E. (n.d.). Focal onset aware seizures (simple partial seizures). Epilepsy Foundation.
Lyrica. (n.d.). Frequently asked questions about Lyrica.
Parke-Davis Div of Pfizer Inc. (2020). LYRICA- pregabalin capsule LYRICA- pregabalin solution [package insert]. DailyMed.
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