Pregabalin

What is pregabalin?

Pregabalin, often sold under the brand name Lyrica, is a medication primarily used to treat neuropathic pain, epilepsy, and generalized anxiety disorder[2]. It belongs to the class of drugs known as gabapentinoids, antiepileptic agents with analgesic properties. 

What is pregabalin used for and how does it work?

Pregabalin is used to treat multiple conditions, including: 

• Neuropathic pain - pain caused by nerve damage, for example; due to diabetes (diabetic neuropathy), shingles (post-herpetic neuralgia), or spinal cord injury[2], by blocking pain messages travelling from the brain and down the spine 

• Fibromyalgia - a condition characterised by widespread musculoskeletal pain[2] 

• Epilepsy - used as an add-on therapy for seizures by reducing abnormal brain activity 

• Generalized anxiety disorder (GAD) - stops your brain from releasing chemicals that cause your anxiety 

How do you take pregabalin?

Pregabalin is taken orally, either as capsules, tablets, oral solution, or extended-release tablets[2][4]. It can be taken with or without food[4]. It's important to follow your doctor's or pharmacist’s instructions regarding dosage and timing as it’s best to take it in the same way each day, spacing out your doses evenly. 

Pregabalin tablets or capsules should be swallowed whole with water or juice – they should not be chewed. Pregabalin in its liquid form will come with a syringe or spoon to measure your dose. Do not use a kitchen teaspoon as it will not measure the correct amount. 

Who can take pregabalin?

Pregabalin is a Schedule 3 Controlled Drug prescription medicine for adults[2]. It is not suitable for children under 18 and it can be unsuitable for people older than 65. It should not be used by individuals who[2]: 

• Are allergic to pregabalin 

• Have severe lung disease or conditions that affect your breathing. 

• Experience mood disorders or suicidal thoughts 

• Have heart problems 

• Have kidney disease or are on a sodium-controlled diet 

• Have a history of drug or alcohol addiction 

• Are trying to get pregnant, already pregnant, or breastfeeding 

Please tell your doctor or pharmacist about any conditions you may have before starting pregabalin, and always follow the instructions in the Patient Information Leaflet[10]. 

What is the typical dosage of pregabalin?

The usual dose of pregabalin is between 150mg and 600mg a day, split into 2 or 3 separate doses, but it varies based on the condition being treated, patient tolerance and the doctor’s or pharmacist’s clinical judgement. Some example doses are as follows[1][5]: 

• Diabetic Neuropathy - initial dose of 50mg three times a day, which can be increased gradually up to a maximum dose of 200mg three times a day[5] 

• Postherpetic Neuralgia - initial dose of 150mg per day, divided into two or three doses[5] 

• Epilepsy - initial dose of 25mg twice daily, increased in steps of 50mg daily up to a maximum of 600mg daily in two or three divided doses.[5] 

• Fibromyalgia - initial dose of 75 mg twice a day, which can be increased to 150mg twice a day[1][5] 

What do you do if you forget to take pregabalin?

If you miss a dose, take it as soon as you remember. If it's within two hours of your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at once and never take an extra dose to make up for forgetting one[2][7]. 

If you have epilepsy, missing doses reduces seizure control and may trigger seizures so it’s important to remember to take the pregabalin regularly.  

What do you do if you take too much pregabalin?

Symptoms of overdose may include severe drowsiness, confusion, seizures, restlessness, and agitation[6][9]. 

If you take more than your prescribed dose, call 111 immediately. If you experience any of the symptoms of overdose listed above, either call 999 and ask for an ambulance or make your own way to your nearest A&E department, bringing with you any remaining medicine, the pregabalin packet or leaflet inside, and any other medicines you take. 

What are the side effects of pregabalin?

The most common side effects of pregabalin include[2][3]: 

• Dizziness 

• Sleepiness 

• Dry mouth 

• Blurred vision 

• Weight gain 

• Difficulty concentrating 

Serious side effects can include[2][3]: 

• Allergic reactions (angioedema) 

• Suicidal thoughts or behaviour 

• Swelling of hands, legs, or feet 

• Kidney damage 

If you experience any of these side effects, stop taking pregabalin and consult your GP or call 111.

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[10].

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice.

Medicines you can and can’t take with pregabalin

Pregabalin can usually be taken safely with other medicines, but for your safety, you should tell your doctor or pharmacist if you’re taking the following before you start taking pregabalin: 

• Strong painkillers like morphine 

• Medicines that can make you feel sleepy or dizzy as pregabalin can make these side effects worse

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[10].

Frequently asked questions about pregabalin

How long does pregabalin take to work?  

Pregabalin usually takes at least a few weeks for it to start to work. 

Can pregabalin cause weight gain?  

Yes, weight gain is a common side effect[2] as it can increase appetite. 

Is pregabalin addictive?  

Pregabalin has a low risk of addiction when taken at usual doses, however some people can become addicted. If this happens, you will experience withdrawal symptoms (such as insomnia, headache, nausea, anxiety, diarrhoea, flu-like symptoms, nervousness, depression, suicidal ideation, pain, seizures, sweating and dizziness) after you stop taking it. 

It is important that you never stop taking pregabalin abruptly without speaking to your doctor or pharmacist first. You should also speak to them if you’re concerned about becoming dependent on pregabalin. 

How do I know if I’m addicted to pregabalin? 

You will likely find it difficult to stop taking it or that you need to take it more often than you’ve been told to.  

You may experience withdrawal symptoms like: 

• Agitation or anxiety 

• Panic attacks 

• Heart palpitations 

• Trouble sleeping 

• Shaking 

• Sweating 

• Aching 

• Restlessness 

How long these symptoms last depends on each person.

Is pregabalin a controlled drug medicine? 

Yes, pregabalin is a controlled drug medicine. This means there are strict rules doctors and pharmacists must follow about how it’s prescribed and dispensed to make sure it goes to the right person and the medication is not misused. 

Controlled Drugs are subject to the special prescription and safe custody requirements, so your doctor or pharmacist may limit the quantity prescribed following the recommendations of the Department of Health and Social Care.  

Can I drink alcohol while taking pregabalin?  

It's best to avoid alcohol as it can increase drowsiness and dizziness[2]. 

Will it affect my contraception or fertility? 

Pregabalin does not stop contraception from working nor is there any evidence to suggest it affects fertility in either men or women. 

However, if pregabalin isn’t working for you and you experience severe diarrhoea for more than 24 hours, your contraceptive pill might not protect you from pregnancy. You should speak to your GP or pharmacist in this instance. 

Can I get pregabalin for epilepsy for free? 

Yes, if you have epilepsy, you’re entitled to free prescriptions for all your medicines, not just epilepsy ones. You just need to fill in the FP92A medical exemption certificate form and get your doctor or pharmacist to sign it and send it off. 

Are there similar medicines to pregabalin? 

Gabapentin, also known as Neurontin, is like pregabalin and can be used for epilepsy and nerve pain, as well as migraines. However, there are differences between them, and gabapentin is usually taken in different doses. Your doctor or pharmacist will explain everything you need to know if you’re changing from pregabalin to gabapentin. 

Can I drive or ride a bike while taking pregabalin? 

If pregabalin makes you sleepy, gives you blurred vision, or makes you feel dizzy, confused or unable to concentrate, then you should not drive or ride a bike. It's an offence to drive if your ability to drive safely is impacted. 

If you have epilepsy, you’re not allowed to drive until you have had no seizures for one year.

For the official NHS guide to pregabalin, visit their website.