Pregabalin (Lyrica): doses, uses, side effects

If you suffer from chronic nerve and muscle pain, you know that it can be debilitating and isolating. Fortunately, treatments are available to help relieve some of the symptoms caused by conditions like fibromyalgia and diabetic peripheral neuropathy; one such treatment is pregabalin. 

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Lyrica (generic name: pregabalin) is a medication healthcare providers prescribe to treat nerve-related pain (Pfizer, 2021). How pregabalin works in the brain isn’t fully understood. The drug has a chemical structure that’s similar to gamma-aminobutyric acid (GABA), a neurotransmitter. Pregabalin seems to work by slowing down certain nerve signals within the brain and nervous system, reducing the activity of the signals involved in seizures and pain perception (Pfizer, 2021).

Pregabalin (Lyrica) is approved by the Food and Drug Administration (FDA) to treat the following conditions in adults (Pfizer, 2021): 

• Fibromyalgia: Fibromyalgia is a complex medical condition that involves chronic, widespread musculoskeletal pain. Other common fibromyalgia symptoms are fatigue and brain fog, and people with fibromyalgia often also have depression or anxiety disorders (Bhargava, 2021).

• Diabetic peripheral neuropathy: Diabetic peripheral neuropathy is a complication of diabetes that causes neuropathic pain, which is pain with numbness, burning, and tingling sensations that usually occur in the hands, feet, arms, and legs. Due to numbness, people with diabetic peripheral neuropathy may not notice something like a minor foot injury, leading to severe foot ulcers (Bodman, 2021).

• Post-herpetic neuralgia: Post-herpetic neuralgia is the medical term for a common long-term complication of herpes zoster infection, commonly called shingles. Post-herpetic neuralgia causes nerve-related pain, numbness, or burning clustered in a band-like pattern across your body (Gruver, 2021). 

• Other uses: Lyrica is also used to treat nerve-related pain associated with spinal cord injury.

Technically, Lyrica is an anticonvulsant (anti-seizure drug). It’s also FDA-approved to treat partial-onset seizures in adults, children, and infants ages one month and older. Also called focal epilepsy, partial-onset seizures occur due to abnormal brain activity that starts on one side of the brain. For this use, a healthcare professional prescribes Lyrica along with other anti-epileptic drugs (AEDs) used to treat or prevent seizures (Patel, 2021; Cross, 2021). 

Pregabalin (Lyrica) is also used “off-label” to treat other conditions besides those specifically approved by the FDA. A healthcare provider can prescribe medications for off-label use if they decide that it’s an appropriate treatment for their patient.

Off-label uses for pregabalin (Lyrica) include (Cross, 2021):

• Generalized anxiety disorder

• Social anxiety disorder

• Bipolar disorder

• Insomnia, a sleep disorder in which you have trouble falling asleep or staying asleep

• Other chronic pain conditions

The most common side effects reported in adults who took pregabalin in clinical trials were (Pfizer, 2021):

• Dizziness

• Drowsiness, sleepiness

• Dry mouth

• Peripheral edema, which is the buildup of fluid in your arms and legs

• Blurred vision

• Weight gain

• Problems with concentration or attention span

The more common side effects of pregabalin reported in children include (Pfizer, 2021):

• Weight gain

• Increased appetite

• Sleepiness

Less frequently, taking pregabalin can cause these serious adverse effects (Pfizer, 2021):

• Severe allergic reactions

• Suicidal behavior or thoughts 

• Excessive sleepiness, dizziness, or severe breathing problems

Because of pregabalin’s possible side effects, healthcare providers advise against driving until you become familiar with how the medication affects you. If you have questions or concerns about the side effects of medications, it’s best to reach out to your healthcare provider or pharmacist. They can provide personalized medical advice.

Pregabalin (Lyrica) is a medication that you take by mouth. It comes in these forms and strengths (Pfizer, 2021):

• Capsule: 25 milligrams (mg), 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, and 300 mg

• Liquid oral solution: 20 mg per milliliter (mL)

The usual starting dosage of pregabalin varies with the condition that a healthcare provider seeks to treat. An example of a typical starting dosage of pregabalin for adults is 50 mg two to three times per day. Your healthcare provider may increase or adjust your dosing based on symptoms, side effects, and other medications. 

You should not change your dose or stop taking this medication without talking to your healthcare provider. 

Before starting pregabalin (Lyrica), it is important to talk to your healthcare provider about your current and past health conditions. Some people may have a higher chance of developing serious side effects (Pfizer, 2021).

Pregabalin (Lyrica) is a schedule V controlled substance because some people may become addicted to it or take more than prescribed. If you’ve had a past problem with alcohol or substance abuse, you may have a higher risk of these issues if you take this medication. Your healthcare provider can discuss these risks with you and work with you to develop a treatment plan that fits your needs (DEA, n.d.).  

If you have depression, there’s a rare but possible chance that pregabalin can make your symptoms more severe. In some cases, people can start having suicidal thoughts or actions. If you notice these changes in your thinking or behavior, help is available. You can contact the National Suicide Prevention Lifeline at 1-800-273-8255 or tell your healthcare provider right away.

Before starting pregabalin treatment, it’s also important to tell your healthcare provider about any problems you've had with your heart, kidneys, or lungs. It’s generally not advised to take pregabalin if you’re pregnant, breastfeeding, or planning to become pregnant. Males are also advised not to take this medication if they plan to father a pregnancy. 

You also should not take pregabalin if you’ve had a past allergic reaction to it or any of its ingredients, as serious allergic reactions have occurred with the use of this medication.

Pregabalin (Lyrica) can interact with several different medications. Some of these interactions may increase the risk of developing harmful side effects.

Some examples of drugs that interact with pregabalin (Lyrica) include (Pfizer, 2021):

• Central nervous system depressants (CNS depressants or “downers”) can be harmful with pregabalin. The combination can increase the risk of a side effect called respiratory depression, which can cause harmfully excessive sleepiness and trouble breathing. Some examples of CNS depressants are:

  • Alcohol

  • Opioids, including prescription painkillers such as hydrocodone, oxycodone, and tramadol

  • Benzodiazepines, which are anxiolytic medications such as Ativan (lorazepam) and Valium (diazepam)

  • Muscle relaxers, such as carisoprodol (Soma)

• Angiotensin-converting enzyme inhibitors (“ACE inhibitors”) are medications used to treat high blood pressure, heart failure, and other heart problems. This drug interaction with pregabalin may increase the chance of a severe allergic reaction called angioedema. This rare but life-threatening reaction causes hives and swelling of the face and throat. Some common examples of ACE inhibitors are:

  • Lisinopril (Prinvil, Zestril)

  • Benazepril (Lotensin)

• Certain diabetes drugs can increase the chances of weight gain or other side effects when combined with pregabalin. These include:

  • Pioglitazone (Actos)

  • Rosiglitazone (Avandia)

The list above only includes some of pregabalin’s more common interactions, but others are possible. So, it’s important to be open with your healthcare provider and pharmacist about all of the medications that you take, including over-the-counter drugs and herbal supplements.

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Current version

August 24, 2021

Written by

Patricia Weiser, PharmD

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.