pregabalin at a glance
Medicine class
Gabapentinoid; also classified as an anti-seizure medicine.
Available forms
Standard tablets, hard capsules, oral solution and prolonged-release tablets.
Food
Standard-release pregabalin can be taken with or without food. Prolonged-release tablets must be taken directly after an evening meal.
Controlled medicine
Pregabalin is a Class C, Schedule 3 controlled drug in Great Britain because of its potential for misuse and dependence.
What is pregabalin used for?
Licensed adult uses depend on the formulation.
Peripheral and central neuropathic pain.
Add-on treatment for partial seizures, with or without secondary generalisation; not sole treatment.
Generalised anxiety disorder.
Prolonged-release Misabri PR is licensed for neuropathic pain, not epilepsy or generalised anxiety disorder.
How does pregabalin work?
Pregabalin binds to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system. This reduces the release of excitatory chemical messengers and dampens abnormal nerve signalling.
pregabalin preparations and strengths
Capsule
Route: Oral
Strengths: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, 300 mg
How to take pregabalin
Follow the label because administration differs between formulations.
Swallow standard tablets or capsules whole, with or without food.
Measure oral solution using the supplied oral syringe and bottle adapter, not a kitchen teaspoon. Rinse the syringe after use.
Take prolonged-release tablets directly after an evening meal and swallow whole. Do not split, crush, chew or break them.
Do not switch between standard-release and prolonged-release pregabalin without prescriber instructions.
Do not stop pregabalin suddenly; plan withdrawal with the prescriber.
pregabalin side effects
Common or expected effects
- Dizziness, sleepiness or headache
- Blurred or double vision
- Poor coordination, balance problems or difficulty concentrating
- Increased appetite or weight gain
- Swelling of the hands, legs or feet
- Nausea, vomiting, constipation, diarrhoea or dry mouth
- Tiredness
Get urgent medical advice
- Shallow, slow or difficult breathing; extreme drowsiness or inability to wake
- Swelling of the face, lips, mouth, tongue or throat
- A blistering, peeling or widespread severe rash
- Thoughts of self-harm or suicide
- Severe dizziness, fainting or loss of consciousness
pregabalin in pregnancy
Some studies suggest a small increase in birth defects after early-pregnancy exposure, although findings are inconsistent and most exposed pregnancies result in a healthy baby. A specialist may use pregabalin when its benefits outweigh possible risks. Discuss pregnancy plans promptly and do not stop treatment without advice, especially for epilepsy. Exposure near delivery may require newborn observation for withdrawal symptoms.
pregabalin while breastfeeding
Pregabalin passes into breast milk in small amounts. It can be used cautiously after individual assessment when breastfeeding a healthy, full-term infant. Monitor for unusual sleepiness, feeding changes, poor weight gain, irritability or gastrointestinal symptoms. Seek specialist advice for a premature or unwell infant or when using several medicines.
pregabalin interactions
Pregabalin has few metabolic interactions, but additive sedation and respiratory depression are important.
Opioids, including oxycodone
May increase sleepiness, impaired coordination, constipation, respiratory depression, coma and risk of death.
Benzodiazepines and other central nervous system depressants
May increase sedation, confusion, falls and breathing problems.
Common questions about pregabalin
Answers are fully visible for fast scanning and source review.
Is pregabalin a painkiller?
It is not a conventional painkiller. It changes nerve signalling and is licensed for peripheral and central neuropathic pain in adults.
Can pregabalin cause addiction or dependence?
Yes. Dependence and addiction can occur even when prescribed. Discuss concerns without stopping suddenly.
Why should pregabalin not be stopped suddenly?
Abrupt stopping can cause withdrawal symptoms and may trigger seizures. Discontinuation should follow an individual plan agreed with the prescriber.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.