pregabalin, Lyrica

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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PREPARATIONS: Capsules: 25, 50, 75, 100, 150, 200, 225, and 300 mg. Oral Solution: 20 mg/ml

PREGNANCY: There are no adequate studies of pregabalin in pregnant women.

It is not known whether pregabalin is excreted in human human milk.

STORAGE: Pregabalin should be stored at room temperature, from 15 C to 30 C (59 F to 86 F).

DOSING: Pregabalin may be taken with or without food. The initial dose for neuropathic pain associated with diabetic peripheral neuropathy is 50 mg three times a day (150 mg/day). The dose may be increased to a maximum dose of 100 mg 3 times daily (300 mg/day) after one week.

The recommended dose for postherpetic neuralgia is 75-150 mg twice daily or 50-100 mg three times daily. Dosing should begin at 75 mg two times a day or 50 mg three times a day (150 mg/day). The dose may be increased to 100 mg 3 times daily (300 mg/day) after one week. If pain relief is inadequate after 2-4 weeks of treatment at 300 mg/day, the dose may be increased to 300 mg twice daily or 200 mg three times daily. Doses greater than 300 mg cause more side effects.

The dose for treating neuropathic pain associated with spinal cord injury is 150 to 600 mg daily. Begin dosing at 75 mg two times a day an increase to 150 mg two times daily after one week if response is inadequate. May increase to 300 mg twice daily if response is inadequate after 2 to 3 weeks.

The recommended dose for treating seizures is 150-600 mg/day divided into 2 or 3 doses, starting at at 150 mg daily and increasing based on response and tolerability. The maximum dose is 600 mg/day.

Fibromyalgia is treated with 300-450 mg/day in 2 or 3 divided doses.

DRUG INTERACTIONS: Alcohol and drugs that cause sedation may increase the sedative effects of pregabalin. Pioglitazone (Actos) and rosiglitazone (Avandia) cause weight gain, fluid retention, and possibly heart failure. Therefore, combining pregabalin with these drugs may increase the occurrence of weight gain and fluid retention.

DRUG CLASS AND MECHANISM: Pregabalin is an oral medication that is chemically related to gabapentin (Gralise, Neurontin). It is used for treating pain caused by neurologic diseases such as postherpetic neuralgia as well as seizures. It also is used for treating fibromyalgia. The mechanism of action of pregabalin is unknown. Pregabalin binds to calcium channels on nerves and may modify the release of neurotransmitters (chemicals that nerves use to communicate with each other). Reducing communication between nerves may contribute to pregabalin's effect on pain and seizures. The FDA approved pregabalin in December 2004.

Medically reviewed by Eni Williams, PharmD

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 3/31/2016

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