Pregabalin

Generic name

Pregabalin

Active ingredient

Pregabalin

Product type

Small-molecule medicine

Drug class

Gabapentinoids

Brand names

UK Alzain, Axalid, Lyrica, Misabri

Routes

Oral

Dosage forms

Capsule, Tablet, Solution

Also known as

Lyrica, Alzain, Axalid, Misabri

Usual preparations

Pregabalin comes as capsules, tablets and a liquid to drink. (summary of the cited reference, not a prescription)

Onset and duration

The NHS says it takes at least a few weeks for pregabalin to work.

Monitoring

The MHRA advises prescribers to assess people for a history of drug abuse before prescribing pregabalin, and to observe them for signs of abuse and dependence. The NHS says blood sugar may need to be checked more often in the first few weeks for people with diabetes.

Availability by country

Legal status differs between countries and can change; each row cites the document it was taken from and applies only to the country named.

What it is used for

• Nerve (neuropathic) pain, including pain from damaged nerves
• Epilepsy
• Generalised anxiety disorder

How it works in the body

For epilepsy, pregabalin is thought to reduce abnormal electrical activity in the brain. For nerve pain, it is thought to block pain by interfering with pain messages travelling through the brain and down the spine. For anxiety, it is thought to stop the brain from releasing the chemicals that make a person feel anxious. MedlinePlus places pregabalin in a group of medicines called anticonvulsants.

Cautions and interactions

• The NHS lists groups who may not be able to take pregabalin, including people who have had an allergic reaction to it, who have ever misused or been addicted to a medicine, or who have breathing problems, heart disease, or liver or kidney disease.
• The NHS says pregabalin in pregnancy is usually only advised if a doctor thinks the benefits outweigh the possible risks, and suggests talking to a doctor or pharmacist before breastfeeding.
• Some brands of pregabalin liquid may contain sodium, so people on a controlled-sodium diet are advised to check first.
• A Dudley NHS leaflet advises against driving when feeling drowsy.
• The NHS says it is best to avoid alcohol, because it may cause sleepiness or poor focus.
• The NHS says pregabalin can intensify the highs of heroin and other opioids.
• The MHRA lists compromised breathing, respiratory or neurological disease, kidney impairment, other medicines that depress the central nervous system, and older age as higher risk for severe breathing difficulty.
• The NHS says pregabalin does not stop any type of contraception working, except that severe diarrhoea lasting more than 24 hours may reduce the protection of contraceptive pills.

Interactions

Interactions documented in the official sources cited on each card. The list covers the medicines represented on this site and is not exhaustive; how the interaction data is compiled.

No pair records for this medicine are in the sources currently represented by Anatomy Nexus. Absence from this list does not mean no interaction exists.

Same-class and related medicines

Same class: Gabapentinoids

Medicines that share the class of Pregabalin. They are separate medicines with their own licences, doses and interactions, not alternative names for Pregabalin.

Related medicines

Medicines often discussed alongside Pregabalin: used together, compared with it, or acting on the same problem by a different route.

Key facts

What is pregabalin used for?

Pregabalin is a prescription medicine used to treat nerve pain, epilepsy and generalised anxiety disorder. Nerve pain, also called neuropathic pain, is pain from damaged nerves. The NHS says nerve pain can be caused by different conditions, such as diabetes and shingles. MedlinePlus says pregabalin is used to relieve neuropathic pain, including pain from diabetes and the pain that can follow shingles. The NHS lists the brand names Alzain, Axalid, Lyrica and Misabri. MedlinePlus places pregabalin in a group of medicines called anticonvulsants. GOV.UK says pregabalin became a Class C controlled drug in April 2019, and that it is illegal to possess it without a prescription or to supply it to others. The NHS says pregabalin comes as capsules, tablets and a liquid to drink.

How does pregabalin work?

The NHS describes how pregabalin works as a theory that differs by condition. For epilepsy, pregabalin is thought to reduce abnormal electrical activity in the brain. For nerve pain, it is thought to block pain by interfering with pain messages travelling through the brain and down the spine. For anxiety, it is thought to stop the brain from releasing the chemicals that make a person feel anxious. One NHS trust leaflet notes that it is not fully understood how pregabalin works. The NHS says it takes at least a few weeks for pregabalin to work. Pregabalin and gabapentin are often grouped together as gabapentinoids. The NHS says gabapentin is thought to work in a similar way for epilepsy and nerve pain. MedlinePlus places pregabalin in a group of medicines called anticonvulsants.

What are the side effects of pregabalin?

The NHS says the most common side effects of pregabalin are feeling sleepy, feeling dizzy and headaches. It says these are usually mild and go away by themselves. NHS trust leaflets list vision disturbances, indigestion, weight gain, leg swelling, tremor and tiredness as other possible effects. A serious allergic reaction (anaphylaxis) is rare, and the NHS lists swelling of the lips, mouth, throat or tongue, or fast or struggling breathing, as signs to call 999. The NHS lists hallucinations (seeing or hearing things that are not there) as a reason to call a doctor or NHS 111 now. A few people taking pregabalin have had suicidal thoughts, which can happen after only a week of treatment. For thoughts of harming oneself or ending one's life, the NHS lists 999 or A&E; NHS 111 (mental health option) and Samaritans on 116 123, free at any time, can also help. The NHS says not to stop pregabalin without talking to the doctor.

Dependence, misuse and stopping pregabalin

The NHS says some people can become addicted to pregabalin. It also says that when stopping, the dose is reduced gradually to avoid withdrawal symptoms, and that pregabalin should not be stopped without talking to the doctor. GOV.UK says pregabalin and gabapentin became Class C controlled drugs, and Schedule 3 under the Misuse of Drugs Regulations 2001, from 1 April 2019. It says it is illegal to possess them without a prescription and illegal to supply or sell them to others. The MHRA advises prescribers to assess people for a history of drug abuse before prescribing pregabalin and gabapentin. It also advises observing people for signs of abuse and dependence. The MHRA says these medicines can cause drowsiness, sedation and potentially fatal respiratory depression, particularly when used with opioid medicines and alcohol. The NHS also says pregabalin can intensify the highs of heroin and other opioids.

Who needs extra care with pregabalin?

The NHS lists groups who may not be able to take pregabalin, including people who have had an allergic reaction to it, have ever misused or been addicted to a medicine, or have breathing problems, heart disease, or liver or kidney disease. The NHS says pregabalin in pregnancy is usually only advised if a doctor thinks the benefits outweigh the possible risks, and suggests talking to a doctor or pharmacist before breastfeeding. The MHRA lists compromised breathing, respiratory or neurological disease, kidney impairment, other medicines that depress the central nervous system, and older age as higher risk for severe breathing difficulty. The NHS says it is best to avoid alcohol, because it may cause sleepiness or poor focus. A Dudley NHS leaflet advises against driving when feeling drowsy. The NHS says pregabalin does not stop any type of contraception working, except that severe diarrhoea lasting more than 24 hours may reduce the protection of contraceptive pills.

Frequently asked questions