Pregabalin

Sounds like 'pree-GAH-ba-lin'

Key points about pregabalin

  • Pregabalin is used to treat some kinds of nerve pain and epilepsy.
  • Pregabalin is also called Lyrica.
  • Find out how to take it safely and possible side effects. 
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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(external link), 2019

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

  • 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:




  • 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. 
  • Don't stop taking pregabalin suddenly: Talk to your doctor before stopping. The dose will need to be reduced over a period of time even if you are taking low doses of pregabalin.

Here are some things to know when you're taking pregabalin. Read the information in the section above on how to take pregabalin and the information in the section below on side effects where you will find important information on dizziness and drowsiness.

  • Storage: Always keep pregabalin in a safe place away from children, and don't share this medicine with others.
  • Other medicines: 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. 

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, don't 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.

For females of child-bearing age

  • This medicine can potentially harm an unborn baby when taken during pregnancy. 
  • Use effective contraception for the whole time you are taking gabapentin.
  • If you're planning a pregnancy talk to your healthcare provider.
  • If you become pregnant, talk to your healthcare provider immediately. If you become pregnant and you're taking gabapentin for epilepsy, don't stop taking the medicine until you have talked to your healthcare provider.

Other things may be important as well, so ask your healthcare provider what you should know about.

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.

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.

Read more about medicines and side effects and reporting a reaction that you think might be a side effect.

The following links have more information on pregabalin.

Pregabalin Pfizer(external link) Medsafe Consumer Information Sheets, NZ
Pregabalin(external link) Rheuminfo

Resource for healthcare providers

B-QuiCK: Gabapentinoids(external link) BPAC, NZ, 2024

References

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

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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