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Pregabalin

Brands and Forms

  • Lyrica
    • capsule: 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg, 300mg.

Uses of Pregabalin

In psychiatry, Pregabalin is used as an adjunct in the treatment of Social Phobia and Generalized Anxiety Disorder, and is also a good choice for treating anxiety symptoms in Bipolar Disorder.

In general medicine, Pregabalin is used to treat seizure disorders, neuropathic pain, and fibromyalgia.

How Pregabalin Works

Pregabalin is an anticonvulsant. It binds to the alpha 2 delta subunit of voltage-gated calcium channels, and in this way decreases neuronal activity.

Cautions when Using Pregabalin

Standard considerations.

Dosing of Pregabalin

The usual therapeutic range of Pregabalin for treating psychiatric disorders is 150-600mg/day, given twice or three times a day. Initial dose is usually 150mg/day in 2 or 3 doses, and the dose can be increased to 300mg/day after a week, and then 600mg/day after another week.

When wanting to stop this medication, the dose should be decreased gradually over a period of at least 1 week.

Onset of action

Therapeutic effects usually require about 2 weeks to appear. If clinical effects do not occur after 6-8 weeks despite dosage increases, then the medication may not work at all.

Kidney impairment

CrCl 30-59mL/min: dose range 75-300mg/day in 2-3 daily doses.
CrCl 16-29mL/min: dose range 25-150mg/day in 1-2 daily doses.
CrCl 15 mL/min: dose range 25-75mg/day in 1 daily dose.
CrCl less than 15 mL/min: reduce dose in proportion to CrCl of 15mL/min (eg, patients with CrCl 7.5 mL/min should receive ½ daily dose of patient with CrCl 15 mL/min).

Liver impairment

No dose adjustment recommended.

Side-effects of Pregabalin

Below is a list of most of the reported side-effects of Pregabalin. Most of these side-effects occur in only a minority of individuals, and many also resolve with time while the medication is continued.

Central Nervous System: dizziness; somnolence; ataxia; headache; tremor; abnormal thinking; unsteadiness; neuropathy; abnormal gait; fatigue; weakness; confusion; speech disorder; memory impairment; disturbances in attention; incoordination; twitching; muscle jerking; vertigo; abnormal feeling; disorientation; lethargy; hypertonia.

Dermatologic: itchiness.

Endocrine/Metabolic: peripheral edema (leg swelling); edema; hypoglycemia.

Eyes, Ears, Nose and Throat: blurred vision; double vision; abnormal vision (5%); throat pain; conjunctivitis, otitis media, tinnitus.

Gastrointestinal: dry mouth; constipation; increased appetite; flatulence; vomiting; distension; gastroenteritis.

Genitourinary: urinary incontinence; loss of orgasm; impotence; urinary frequency.

Hematologic: easy bruising.

Muskuloskeletal: back pain; muscle spasm; leg cramps; muscle pains; joint pains; myasthenia.

Psychiatric: depressed mood; anxiety; nervousness; disinhibition (drunk feeling); depersonalization.

Respiratory: sinusitis; bronchitis; shortness of breath.

Common side-effects of Pregabalin

Dizziness, somnolence, ataxia, headache, tremor, abnormal thinking, balance disorder, neuropathy, abnormal gait, fatigue, blurred vision, diplopia, dry mouth, constipation, peripheral edema, weight gain, infection, accidental injury.

Rare but serious side-effects of note of Pregabalin

None of note.

Pregabalin overdose

No fatalities reported.

Pregabalin and pregnancy

Category C: some animal studies show adverse effects at very high doses, but no controlled human studies have been done; should only be used in pregnancy if clearly needed and if benefits outweigh potential risks.

Medical Monitoring for Pregabalin

None for healthy individuals.

Drug Interactions with Pregabalin

  • Use caution when combining with other sedating medications, including benzodiazepines, narcotics, and alcohol.