Pregabalin

Sounds like 'pree-GAH-ba-lin'

Pregabalin is used to treat some kinds of nerve pain and epilepsy. Find out how to take it safely and possible side effects. Pregabalin is also called Lyrica.

Type of medicine Also called
  • Pain medication
  • Pregabalin Pfizer®
  • Lyrica®

What is pregabalin?

Pregabalin is used to relieve nerve pain (also called neuropathy). Nerve pain occurs when damage or changes to your nerves, through injury or disease such as diabetes or shingles, causes them to misfire and send pain signals to your brain. Read more about nerve pain

Pregabalin is also used to treat epilepsy, by preventing some types of seizures, and can also be helpful in treating the symptoms of generalised anxiety disorder, if other medicines are not suitable. 

In New Zealand, pregabalin is available as capsules (25 mg, 75 mg, 150 mg and 300 mg).  

Credits: RheumInfo, 2019

Note: this video is from Canada so may have information that differs from New Zealand recommendations.

Dose

  • The usual dose of pregabalin is 150 mg 2 times a day, but some people may need a higher dose.
  • Your doctor will start you on a low dose of 75 mg two times a day and increase the dose after a few days. This allows your body to get used to the medicine and reduces the chances of side effects.
  • Always take your pregabalin exactly as your doctor has told you.
  • The pharmacy label on your medicine will tell you how much pregabalin to take, how often to take it and any special instructions.

My dose is:

Date Morning Evening
     
     
     
Notes:




How to take pregabalin

  • Timing: You can take pregabalin with or without food. Try taking pregabalin with food if it makes you feel sick (nausea). Take pregabalin at the same times each day. You need to take pregabalin regularly and not just when your nerve pain gets bad.  
  • Swallow the capsules whole, with a glass of water: Do not open the capsules. If you have problems swallowing pregabalin capsules, talk to your doctor or pharmacist. Read more about tips for swallowing tablets and capsules.  
  • Limit or avoid alcohol while taking pregabalin: Taking pregabalin and alcohol can make you more sleepy, drowsy or dizzy and increase your risk of falls.
  • Missed dose: If you forget to take your dose, take it as soon as you remember that day. But if it is nearly time (within 4 hours) for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Pain relief is not immediate: If you are taking pregabalin for pain, it does not relieve pain immediately. It may take a few days before you feel less pain. 
  • Keep taking pregabalin regularly: If you think pregabalin is not working for you, do not stop taking it suddenly. Stopping treatment suddenly can cause side effects. Speak to your doctor or nurse before stopping. It is usually best to stop pregabalin slowly.

Precautions before starting pregabalin

  • Do you have kidney problems?
  • Do you have problems with your heart?
  • Do you have diabetes?
  • Are you pregnant or breastfeeding?
  • Are you taking any other medicines? This includes any medicines you buy without a prescription, such as herbal and complementary medicines and medicines for pain relief.

If so, it’s important that you tell your doctor or pharmacist before you start pregabalin. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

What are the side effects of pregabalin?

Like all medicines, pregabalin can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Problems with dizziness and drowsiness

This is quite common when you start taking pregabalin. Up to 1 in 3 people experience dizziness or drowsiness. 

  • Be careful when driving or using tools until you know how this medicine affects you.
  • Also be careful when getting up from either lying down or sitting. The loss of balance and dizziness can put you at risk of falls and injuries, especially if you are elderly.
  • Avoid drinking alcohol while you are taking pregabalin. This can make dizziness and drowsiness worse.

Tell your doctor if these side effects are causing you problems. You may need a lower dose.

Risk of dependence

Pregabalin can cause feelings of excitement and exaggerated happiness (often described as a high or euphoria). For some people, it can become habit forming. The risk of dependence may be higher if you have a history of misuse of alcohol and recreational drugs and if you are taking pregabalin in combination with certain other medicines.

To avoid pregabalin dependence, do not take higher doses, more frequent doses or for longer than you were prescribed by a doctor. Let your doctor know if you have any history of drug abuse or start to feel any sense of high or desire for your next dose or if you start taking any new medicines for pain relief.

Always keep pregabalin in a safe place away from children, and do not share this medicine with others.

Other side effects

Side effects What should I do?
Weight gain
  • This is quite common in the first few months of starting pregabalin.
  • Most people gain less than 2 kilograms, but up to 15% of people, depending on dose, gain more than 5 kilograms.
  • Follow a healthy diet and exercise regularly.
  • Nausea (feeling sick)
  • Vomiting
  • Dry mouth
  • Blurred vision
  • Tell to your doctor.
Constipation
  • Ask your doctor to prescribe a suitable laxative, which you need to take on a regular basis.
  • You also need to eat more fruit, vegetables, brown bread and bran-based breakfast cereals and drink plenty of water.
Frequent mood changes, anxiety, depression, thoughts of suicide, abnormal behaviours
  • Tell your doctor immediately or phone Healthline 0800 611 116.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product

Interactions

Pregabalin interacts with a number of medicines and herbal supplements so check with your doctor or pharmacist before starting pregabalin and before starting any new medicines. 

Learn more

The following links have more information on pregabalin.

Pregabalin Pfizer Medsafe Consumer Information Sheets, NZ
Pregabalin Rheuminfo

References

  1. Spotlight on gabapentin and pregabalin for neuropathic pain Medsafe, 2021
  2. Prescribing gabapentin and pregabalin: upcoming subsidy changes BPAC, NZ, 2018
  3. Managing patients with neuropathic pain BPAC, NZ, 2016

Additional resources for healthcare professionals

Antiepileptic medicines and suicide prescriber update Medsafe, NZ, 2016

Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 17 Mar 2021