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pregabalin

Pronunciation

Generic Name: pregabalin (pre GAB a lin)
Brand Name: Lyrica

What is pregabalin?

Pregabalin is an anti-epileptic drug, also called an anticonvulsant. It works by slowing down impulses in the brain that cause seizures. Pregabalin also affects chemicals in the brain that send pain signals across the nervous system.

Pregabalin is used to control seizures and to treat fibromyalgia. It is also used to treat pain caused by nerve damage in people with diabetes (diabetic neuropathy), herpes zoster (post-herpetic neuralgia), or spinal cord injury.

Pregabalin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about pregabalin?

Pregabalin can cause a severe allergic reaction. Stop taking this medicine and seek emergency medical help if you have hives or blisters on your skin, trouble breathing, or swelling in your face, mouth, or throat.

Some people have thoughts about suicide while taking pregabalin. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

If you have diabetes or heart problems, call your doctor if you have weight gain or swelling in your hands or feet while taking pregabalin.

Do not stop using pregabalin suddenly, even if you feel fine. Stopping suddenly may cause withdrawal symptoms.

What should I discuss with my healthcare provider before taking pregabalin?

You should not use pregabalin if you are allergic to it.

To make sure pregabalin is safe for you, tell your doctor if you have ever had:

  • a mood disorder, depression, or suicidal thoughts;

  • heart problems (especially congestive heart failure);

  • a bleeding disorder;

  • low levels of platelets in your blood;

  • kidney disease (or if you are on dialysis);

  • diabetes (unless you are taking pregabalin to treat diabetic neuropathy);

  • drug or alcohol addiction; or

  • a severe allergic reaction (angioedema).

Some people have thoughts about suicide while taking pregabalin. Your doctor will need to check your progress at regular visits while you are using topiramate. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Follow your doctor's instructions about taking seizure medication if you are pregnant. Seizure control is very important during pregnancy, and having a seizure could harm both mother and baby. Do not start or stop taking this medicine without your doctor's advice, and tell your doctor right away if you become pregnant.

If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of pregabalin on the baby.

This medication can decrease sperm count and may affect fertility in men (your ability to have children). In animal studies, pregabalin also caused birth defects in the offspring of males treated with this medicine. However, it is not known whether these effects would occur in humans. Ask your doctor about your risk.

It is not known whether pregabalin passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

Pregabalin is not approved for use by anyone younger than 18 years old.

How should I take pregabalin?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take the medicine at the same time each day.

You may take pregabalin with or without food.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not stop using pregabalin suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Call your doctor if your symptoms do not improve, or if they get worse.

Wear a medical alert tag or carry an ID card stating that you take pregabalin. Any medical care provider who treats you should know that you take seizure medication.

Store at room temperature away from moisture, light, and heat.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking pregabalin?

Avoid drinking alcohol. It may increase certain side effects of pregabalin.

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Pregabalin side effects

Pregabalin can cause a severe allergic reaction. Stop taking this medicine and get emergency medical help if you have: hives or blisters on your skin; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, depression, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • vision problems;

  • swelling in your hands or feet, rapid weight gain (especially if you have diabetes or heart problems); or

  • unexplained muscle pain, tenderness, or weakness (especially if you also have fever, unusual tiredness, or dark colored urine).

If you have diabetes, tell your doctor right away if you have any new sores or other skin problems.

Common side effects may include:

  • dizziness, drowsiness;

  • trouble concentrating;

  • swelling, weight gain;

  • dry mouth; or

  • blurred vision.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregabalin dosing information

Usual Adult Dose for Diabetic Neuropathy:

-Initial dose: 50 mg orally 3 times a day
-Titration: The dose may be increased to 100 mg orally 3 times a day within 1 week based on efficacy and tolerability
-Maximum dose: 100 mg orally 3 times a day in patients with a creatinine clearance of at least 60 mL/min

Comment:
-This drug may be taken with or without food.

Use: Management of neuropathic pain associated with diabetic peripheral neuropathy

Usual Adult Dose for Postherpetic Neuralgia:

-Initial dose: 75 mg orally 2 times a day OR 50 mg orally 3 times a day
-Titration: The dose may be increased to 100 mg orally 3 times a day within 1 week based on efficacy and tolerability
-Maintenance dose: 75 to 150 mg orally 2 times a day OR 50 to 100 mg orally 3 times a day (150 to 300 mg/day) in patients with a creatinine clearance of at least 60 mL/min
-Maximum dose: Patients who do not experience sufficient pain relief following 2 to 4 weeks of treatment with 300 mg/day and who are able to tolerate this drug, may be treated with up to 300 mg orally 2 times a day or 200 mg orally 3 times a day (due to the dose-dependent adverse effects and the higher rate of treatment discontinuation due to adverse events, dosing above 300 mg/day should be reserved only for those patients who have ongoing pain and are tolerating 300 mg daily)

Comment:
-This drug may be taken with or without food.

Use: Management of postherpetic neuralgia

Usual Adult Dose for Epilepsy:

-Initial dose: 75 mg orally 2 times a day OR 50 mg orally 3 times a day
-Maintenance dose: 150 mg/day to 600 mg/day (the total daily dose should be divided and given either 2 or 3 times a day)
-Maximum dose: 600 mg/day in 2 or 3 divided doses based on individual patient response and tolerability

Comments:
-This drug may be taken with or without food.
-The efficacy of add-on therapy in patients taking gabapentin has not been evaluated in controlled trials; therefore, dosing recommendations for the use of this combination cannot be offered.

Use: Adjunctive therapy for adult patients with partial onset seizures

Usual Adult Dose for Fibromyalgia:

-Initial dose: 75 mg orally 2 times a day (150 mg/day)
-Titration: The dose may be increased to 150 mg orally 2 times a day (300 mg/day) within 1 week based on efficacy and tolerability
-Maintenance dose: 300 to 450 mg/day in 2 divided doses
-Maximum dose: Patients who do not experience sufficient benefit with 300 mg/day may be further increased to 225 mg orally 2 times a day (450 mg/day)

Comments:
-This drug may be taken with or without food.

Use: Management of fibromyalgia

Although pregabalin was also studied at 600 mg/day, there is no evidence that this dose confers additional benefit and this dose was less well tolerated. In view of the dose-dependent adverse reactions, treatment with doses above 450 mg/day is not recommended.

Usual Adult Dose for Neuropathic Pain:

-Initial dose: 75 mg orally 2 times a day
-Titration: The dose may be increased to 150 mg orally 2 times a day within 1 week based on efficacy and tolerability
-Maintenance dose: 150 to 600 mg/day in divided doses
-Maximum dose: Patients who do not experience sufficient pain relief after 2 to 3 weeks of treatment with 150 mg orally 2 times a day and who tolerate this drug may be treated with up to 300 mg orally 2 times a day

Comments:
-This drug may be taken with or without food.

Use: Neuropathic pain associated with spinal cord injury

What other drugs will affect pregabalin?

Taking pregabalin with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, narcotic (opioid) medication, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • oral diabetes medicine--pioglitazone, rosiglitazone; or

  • an ACE inhibitor--benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril.

This list is not complete. Other drugs may interact with pregabalin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

See also: Side effects (in more detail)

Where can I get more information?

  • Your pharmacist can provide more information about pregabalin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.01.

Date modified: October 13, 2017
Last reviewed: August 07, 2017

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