Pregabalin is an antiepileptic and neuropathic pain reliever. It is a gabapentinoid with higher affinity for the α2δ subunit than gabapentin.
Also known as: lyrica
DailyMed/FDA — Lyrica; EMC-UK — Pregabalin
DailyMed/FDA — Lyrica; EMC-UK
Two gabapentinoids: additive CNS depression. Do not combine without justification.
Both act on the α2δ subunit of voltage-gated calcium channels. The combination offers no additional therapeutic benefit (same mechanism) and significantly increases the risk of sedation, dizziness, ataxia, and respiratory difficulty. Do not combine two gabapentinoids — choose one based on the indication.
Two gabapentinoids: additive CNS depressant effect without additional therapeutic benefit.
Both act on the α2δ subunit of calcium channels. The combination offers no additional therapeutic benefit and increases risk of sedation, dizziness, and respiratory difficulty.
Sedation, respiratory function.
Respiratory depression.
Do not combine two gabapentinoids. Choose one.
DailyMed/FDA; EMC-UK
No documented food or drink interactions.
90% excreted unchanged renally. Significant accumulation in renal impairment.
eGFR 30-59: reduce to 75-300 mg/day. eGFR 15-29: 25-150 mg/day. eGFR <15: 25-75 mg/day.
DailyMed/FDA; EMC-UK
Animal studies show reproductive toxicity. Limited human data. Use minimum effective dose.
Insufficient data. Use minimum dose and short duration.
Excreted in breast milk. Decision between discontinuing breastfeeding or drug.
Effects on fertility in animals. Insufficient human data.
DailyMed/FDA — Lyrica; EMC-UK
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
Antiepileptic and neuropathic pain activity. Higher α2δ subunit affinity than gabapentin.
Selectively binds to the α2δ subunit of voltage-gated calcium channels. 6-fold higher affinity than gabapentin. Reduces excitatory neurotransmitter release in the CNS and spinal cord.
Rapid and linear oral absorption. Bioavailability: >90%. Peak: 1-2 h. Food does not significantly affect Cmax.
Minimal metabolism (<2%). Not a substrate or significant inhibitor of CYP. Renal excretion (90% unchanged).
6.3 h.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
