Pregabalin

(pre-gab-uh-lin)

Trade/other name(s): Lyrica

Why would this drug be used?

Pregabalin is used as a non-opioid pain reliever. It belongs to a general class of drugs called anticonvulsants (anti-seizure drugs). Pregabalin may be given to help control neuropathic pain (numbness, tingling, burning, shooting, or electric-shock-like pain.) It is also used to help prevent seizures and for other purposes.

How does this drug work?

The exact way that pregabalin works is not fully understood. It appears to reduce the number of pain signals that travel along the nerves.

Before taking this medicine

Tell your doctor…

• If you are allergic to anything, including medicines, dyes, additives, or foods.
• If you have kidney disease. Your dose of pregabalin may need to be lowered.
• If you have diabetes. This drug may cause weight gain, which can worsen the problem.
• If you have heart problems, including heart failure. This drug can cause weight gain and swelling, which may worsen this condition.
• If you have had a problem with drug abuse, alcoholism, or addiction. Pregabalin can cause some people to feel "high."
• If you have bleeding problems. This drug may lower the platelet count and raise the risk of bleeding.
• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. In animal studies, fetal harm occurred when the mother was given the drug during pregnancy. The male sperm was also affected and caused birth defects. There may be an increased risk of harm to the fetus if a woman takes this drug during pregnancy, or if a man fathers a child while his sperm are affected by this drug. No studies in humans have been done.
• If you are breast-feeding. It is not known if this drug passes into breast milk. If it does, it may affect the baby.

About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

In those taking pregabalin, the anti-diabetic drugs rosiglitazone and pioglitazone may cause weight gain and swelling.

Medicines that slow down the brain or nervous system, such as other pain relievers, tranquilizers, sedatives, sleeping pills, antidepressants, muscle relaxers, antihistamines, phenothiazines, anesthetic medicines, and alcohol can cause worse side effects, such as reduced alertness, sleepiness, and similar effects if taken with pregabalin.

Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

This drug comes in capsule form and is usually taken 2 to 3 times a day, as directed by your doctor. The dose is usually started low and gradually increased over a few days until an effective dose is reached. It can be taken with or without food.

Pregabalin should not be stopped suddenly, but tapered down over the course of a week or more. Talk with your doctor or nurse before changing your dose.

Take this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you.

Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets.

Precautions

This medicine can cause drowsiness, dizziness, and trouble thinking. Do not drive, operate machinery, or perform other activities that require mental alertness or physical coordination until you know how you react to this medicine.

Report muscle pain, tenderness, or weakness to your doctor right away, especially if you also have fever or feel sick.

Call your doctor or nurse if you have changes in your vision.

Call your doctor or nurse if you notice rash, skin sores, or itching.

If you develop confusion, problems with coordination and balance, or other serious brain or nervous system effects, call your doctor.

If you notice strange or unusual thoughts or behavior while on this medicine, call your doctor. A few people start to think about suicide and may hurt themselves. Rarely, people get confused, agitated, or start seeing or hearing things that are not there. Tell family members, loved ones, and caregivers that you are taking this drug so that they can help you if they notice behavior changes.

This drug may lower the platelet count in a few people. This can increase the risk of bleeding. Tell your doctor right away if you have unusual bruising, or bleeding such as nosebleeds, bleeding gums when you brush your teeth, or black, tarry stools.

If you have trouble breathing, wheezing, or swelling of the face, mouth, or throat, get emergency help.

Avoid drinking alcohol while taking this medicine.

If you are using pregabalin for chronic (long term) cancer pain, talk with your doctor or nurse about taking your pain medicines on a regular schedule to keep it from worsening. If you wait until the pain is bad, it takes more medicine to get it under control. If pain comes back between doses, talk to your cancer team about changing your medicine or adding an extra one for "breakthrough" pain.

Most cancer pain can be controlled. Keep your doctor or nurse informed about how well your pain medicines are working and any side effects you are having. Your cancer team may need to adjust your medicines several times before they find the medicines that work best for you.

Talk to your doctor or nurse before stopping this medicine. The dose should be lowered slowly, over at least a week, to prevent nausea, headache, trouble sleeping, and diarrhea. Do not change your dose without talking to your doctor.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

• dizziness*
• sleepiness*

Less common

• low blood pressure, feeling faint
• blurred vision*
• trouble walking, balance problems*
• poor coordination*
• poor concentration*
• loss of memory
• dry mouth
• rapid weight gain
• swelling of hands and feet, bloating
• nausea, diarrhea, headache, and trouble sleeping if medicine is stopped suddenly*

Rare

• weakness
• abnormal thinking
• confusion*
• mouth ulcers
• low platelet count, with increased risk of bleeding*
• muscle pain or weakness*
• allergic reaction*
• swelling of the mouth, throat, or face*
• trouble breathing*
• muscle breakdown*
• tiredness
• twitching or jerking
• suicidal thoughts and actions*

*See the "Precautions" section for more detailed information.

There are other side effects not listed above can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 2004

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.