Pregabalin

About Pregabalin

Pregabalin is an anticonvulsant; MedlinePlus says it works by decreasing the number of pain signals sent out by damaged nerves. Lyrica capsules and oral solution are labeled in adults for nerve pain from diabetic peripheral neuropathy, postherpetic neuralgia (pain after shingles) and spinal cord injury, and for fibromyalgia, and as add-on therapy for partial-onset seizures from 1 month of age. They are taken two or three times a day, starting at 150 mg a day for adults; the maximum is 300 mg a day for diabetic nerve pain, 450 mg for fibromyalgia and 600 mg for shingles pain, spinal cord injury pain and seizures, and children with seizures are dosed by weight. Lyrica CR starts at 165 mg once a day after the evening meal and can reach 330 mg within a week (up to 660 mg for shingles pain); it is not labeled for children. Doses are lowered for reduced kidney function.

Pregabalin has no boxed warning. Its warnings cover angioedema (swelling of the face, mouth or throat, which can be life-threatening), which may be more likely with ACE inhibitors, and other allergic reactions; serious breathing problems with opioids or other sedatives or in people with lung disease, a risk the FDA has said is also higher in older adults; dizziness and sleepiness that impair driving; swelling of the hands and feet and weight gain; blurred vision; raised creatine kinase, a muscle enzyme; lower platelet counts; and, as with all antiepileptic drugs, a higher risk of suicidal thoughts or behavior. Anyone allergic to it must not take it. Dizziness, sleepiness, dry mouth, swelling, blurred vision, weight gain and trouble concentrating are the most common side effects in adults.

Pregabalin is a Schedule V controlled substance. Part 1306 of the federal rules sets no refill limit for Schedule V, so a prescription carries the refills the prescriber authorizes where state law allows, and refill information can be transferred between pharmacies only once unless they share a real-time online database (21 CFR 1306.25). Stopping suddenly can cause insomnia, nausea, headache, anxiety, sweating and diarrhea, and more seizures in epilepsy, so it is tapered over at least a week; April 2025 label updates added that suicidal thoughts and behavior have been reported after stopping. Observational studies suggest a possible small increase in major birth defects, with no consistent pattern; long-term use with opioids close to delivery may raise the risk of withdrawal in the newborn; and because of a potential tumor risk seen in mouse studies, the label does not recommend breastfeeding.

Taking Pregabalin

How to take it

Capsules and solution two or three times a day, with or without food. Take Lyrica CR once a day after the evening meal, swallowed whole, never split, crushed or chewed. Do not stop it on your own.

If you miss a dose

Capsules or solution: take it when you remember, unless the next dose is almost due; then skip it. Lyrica CR: if you miss it after the evening meal, take it at bedtime after a snack; if you miss that, after breakfast; if you miss that too, at the usual time after the evening meal. Never take a double dose.

Storage

At room temperature, tightly closed, away from heat and moisture (not in the bathroom), out of reach of children.

Interactions to know about

Opioids, benzodiazepines, alcohol and other sedatives add to dizziness and sleepiness and can slow breathing dangerously. ACE inhibitors such as lisinopril may raise the risk of angioedema, and thiazolidinedione diabetes medicines such as pioglitazone add to swelling and weight gain. Other medicines are unlikely to change its levels.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Pregabalin differs from pharmacy to pharmacy

Generic capsules have many makers, while the oral solution and the extended-release tablets have only a few, and a prescription that names Lyrica or Lyrica CR without allowing substitution is priced as a brand. Doses are split through the day, so the capsule count depends on the strengths written, and extended-release tablets cannot be swapped at the counter for capsules.

Because refill information for a controlled substance can usually move between pharmacies only once, quotes are worth comparing before the first fill.

Ways to pay less for Pregabalin without insurance

• Ask for generic pregabalin capsules, and check that the prescription does not name Lyrica only.
• Compare more than one pharmacy before the first fill.
• Once your dose is settled, ask the prescriber whether a ninety-day supply would suit you.
• If extended-release tablets or the oral solution are prescribed, ask for a generic rated to that form, or ask the prescriber whether capsules would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Pregabalin

1. 1.How many refills does my prescription carry, and could they move with me to another pharmacy?
2. 2.Is it safe with my opioid, sleep or anxiety medicines, or with my lung condition?
3. 3.Is my dose right for my kidney function?
4. 4.What should I do if I miss my Lyrica CR dose after dinner?

Related medications