Lyrica vs. Tramadol

• Lyrica (pregabalin) and tramadol are used to treat pain.
• Lyrica is used to treat neuropathic pain associated with diabetic peripheral neuropathy or postherpetic neuralgia, and fibromyalgia. Lyrica is also used in combination with other drugs to treat partial onset seizures in adults.
• Tramadol is used to manage moderate to moderately severe pain.
• Brand names for tramadol include Ultram, Ultram ER, and Conzip.
• Lyrica and tramadol belong to different drug classes. Lyrica is an anti-epileptic drug (AED) and tramadol is a pain reliever (analgesic).
• Side effects of Lyrica and tramadol that are similar include dizziness, nausea, dry mouth, constipation, drowsiness, and visual disturbances (including blurred vision, double vision).
• Side effects of Lyrica that are different from tramadol include fatigue, fluid retention (edema), weight gain, abnormal gait, tremor, difficulty concentrating, increased appetite, gas, amnesia, disorientation, myoclonus (sudden, involuntary jerking of a muscle or muscle groups), heart failure, low blood pressure, vomiting, reduced blood platelet counts, and increased blood creatinine kinase levels.
• Side effects of tramadol that are different from Lyrica include headache, euphoria, indigestion, muscle stiffness, weakness, vomiting, itching, sweating, diarrhea, rash, and spinning sensation (vertigo).
• Withdrawal symptoms may occur if you suddenly stop taking tramadol.

Lyrica (pregabalin) is an oral medication chemically related to gabapentin (Gralise, Neurontin) used to treat pain caused by neurologic diseases such as postherpetic neuralgia as well as seizures. It also is used to treat fibromyalgia.

Tramadol is a pain reliever (analgesic) used to manage moderate to moderately severe pain. The mechanism of action of tramadol is similar to morphine. Like morphine, tramadol binds to receptors in the brain (narcotic or opioid receptors) that are important for transmitting the sensation of pain from throughout the body to the brain. Like other narcotics used to treat pain, patients taking tramadol may abuse the drug and become addicted to it.

Lyrica

Warning

Antiepileptic medications have been associated with increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.

The most common side effects of Lyrica are

• dizziness,
• drowsiness,
• dry mouth (xerostomia),
• edema (accumulation of fluid),
• blurred vision,
• double vision (diplopia),
• weight gain,
• fatigue (tiredness),
• abnormal gait (ataxia),
• tremor, and
• difficulty concentrating.

Other side effects include

• constipation,
• increased appetite,
• nausea,
• flatulence,
• amnesia,
• disorientation,
• myoclonus (sudden, involuntary jerking of a muscle or muscle groups),
• heart failure,
• low blood pressure,
• vomiting,
• reduced blood platelet counts, and
• increased blood creatinine kinase levels.

Increased creatinine kinase can be a sign of muscle injury, and in clinical trials three patients experienced rhabdomyolysis (severe muscle injury). Therefore, patients should report unexplained muscle pain, tenderness or weakness to their doctors, especially if associated with fever and malaise (reduced well-being). Lyrica has rarely been associated with angioedema (swelling of the face, tongue, lips, and gums, throat and larynx).

Tramadol

Tramadol is generally well tolerated, and side effects are usually temporary.

Commonly reported side effects include:

• nausea,
• constipation,
• dizziness,
• headache,
• euphoria,
• indigestion,
• spasticity,
• weakness,
• drowsiness, and
• vomiting.

Less commonly reported side effects include:

• itching,
• sweating,
• dry mouth,
• diarrhea,
• rash,
• visual disturbances, and
• vertigo.

Some patients who received tramadol have reported seizures. It may cause serotonin syndrome when combined with other drugs that also increase serotonin (see drug interactions section).

Lyrica

Addiction is not a listed side effect of Lyrica

Tramadol

Tramadol is a narcotic and is addictive. Tramadol is a Schedule IV controlled substance that has been associated with addiction, abuse, and misuse. Tramadol may be addictive, even at the dosage your doctor has prescribed. Abuse or misuse of tramadol can lead to overdose and death.

Like other opioids, people who take tramadol for a long time will develop withdrawal symptoms if your doctor reduces the dosage, or if you suddenly stop taking tramadol.

Withdrawal symptoms that may occur include:

• Restlessness
• Excessive tear production
• Yawning
• Sweating
• Chills
• Muscle pain
• Anxiety
• Backache
• Joint pain
• Weakness
• Abdominal cramps
• Insomnia
• Nausea
• Weight loss
• Vomiting
• Diarrhea
• Increased blood pressure
• Respiratory rate
• Heart rate

Infants born to mothers who were taking tramadol during the pregnancy will develop symptoms of withdrawal and difficulty breathing.

Lyrica

• Lyrica may be taken with or without food.
• Treating diabetic peripheral neuropathy: 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.
• Treating postherpetic neuralgia: 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.
• Treating neuropathic pain associated with spinal cord injury: 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.
• Treating seizures: The recommended dose for treating seizures is 150-600 mg/day divided into 2 or 3 doses, starting at 150 mg daily and increasing based on response and tolerability. The maximum dose is 600 mg/day.
• Treating fibromyalgia: Fibromyalgia is treated with 300-450 mg/day in 2 or 3 divided doses.

Tramadol

• The recommended dose of tramadol is 50-100 mg (immediate-release tablets) every 4-6 hours as needed for pain.
• The maximum dose is 400 mg/day.
• To improve tolerance patients should be started at 25 mg/day, and doses may be increased by 25-50 mg every 3 days to reach 50-100 mg/day every 4 to 6 hours.
• The recommended dose for extended-release tablets is 100 mg daily, which may be increased by 100 mg every 5 days, but not to exceed 300 mg /day. To convert from immediate release to extended release, the total daily dose should be rounded down to the nearest 100 mg. Extended-release tablets should be swallowed whole and not crushed or chewed.
• Tramadol may be taken with or without food.

Lyrica

• 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.

Tramadol

• Carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol) reduces the effect of tramadol by increasing its inactivation in the body.
• Quinidine (Quinaglute, Quinidex) reduces the inactivation of tramadol, thereby increasing the concentration of tramadol by 50% to 60%.
• Combining tramadol with monoamine oxidase inhibitors or MAOIs (for example, tranylcypromine [Parnate]) or selective serotonin inhibitors (SSRIs), for example, fluoxetine (Prozac), may result in severe side effects such as seizures or a condition called serotonin syndrome.
• Tramadol may increase central nervous system and respiratory depression when combined with alcohol, anesthetics, narcotics, tranquilizers, or sedative hypnotics. This can reduce the level of consciousness or lead to respiratory insufficiency.

Lyrica

• There are no adequate studies of Lyrica in pregnant women.
• It is not known whether Lyrica is excreted in breast milk.

Tramadol

• Researchers have not established the safety of tramadol during pregnancy, The safety of tramadol during pregnancy has not been established.
• Mothers who are breastfeeding should not take tramadol because the infant may develop side effects, and will develop symptoms of withdrawal and difficulty breathing.