pregabalin 

(Rx)
Brand and Other Names:Lyrica, Lyrica CR

 Classes: Analgesics, Other;
 Anticonvulsants, Other;
 Fibromyalgia Agents

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Sections

 Sections pregabalin
 Dosing & Uses
 Interactions
 Adverse Effects
 Warnings
 Pregnancy
 Pharmacology
 Administration
 Images
 Patient Handout
 Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule: Schedule V

 25mg
 50mg
  75mg
 100mg
 150mg
 200mg
 225mg
 300mg

oral solution: Schedule V

 20mg/mL

tablet, extended-release: Schedule V

 82.5 mg
 165 mg
 330 mg

Diabetic Peripheral Neuropathic Pain

Regular-release capsules

 Initial: 50 mg PO q8hr
 Maintenance: May increase to 100 mg PO q8hr within 1 week, as needed; not to exceed
300 mg/day

Extended-release tablets

 Initial: 165 mg PO qDay

 Maintenance: May increase to 330 mg PO qDay within 1 week based on response and
tolerability; not to exceed 330 mg PO qDay
 See also Administration

Postherpetic Neuralgia

Regular-release capsules

 Initial: 150-300 mg/day PO divided q8-12hr

 Maintenance: May increase to 300 mg/day divided q8-12hr after 1 week, as needed

Extended-release tablets

 Initial: 165 mg PO qDay

 Maintenance: May increase to 330 mg PO qDay within 1 week based on response and
tolerability; not to exceed 330 mg PO qDay
 Patients experiencing insufficient pain relief following 2-4 weeks of treatment with 330
mg PO qDay and tolerate the ER tablets, may be treated with up to 660 mg PO qDay
Fibromyalgia

Regular-release capsules and oral solution only

Initial: 75 mg PO q12hr (150 mg/day)

Maintenance: May increase to 150mg q12hr after 1 week as needed; recommended dose is 300-
400 mg/day

Owing to dose-dependent adverse reactions, doses >450 mg/day are not recommended

Partial Onset Seizures

Regular-release capsules and oral solution only

Indicated as adjunctive therapy for treatment of partial onset seizures

Initial: 150 mg/day PO divided q8-12hr

Maintenance: Based on clinical response and tolerability, may increase dose in weekly
increments, not to exceed 600 mg/day

Efficacy of adjunctive pregabalin in patients taking gabapentin has not been evaluated in
controlled trials; consequently, no dosing recommendations can be made when pregabalin is
used with gabapentin

Neuropathic Pain With Spinal Cord Injury

Regular-release capsules and oral solution only

Initial: 75 mg PO q12hr (150 mg/day); may increase within 1 week to 300 mg/day PO divided
q12hr

If there is insufficient pain relief after 2-3 weeks and 300 mg/day dose is tolerated, may increase
dose again up to 600 mg/day PO divided q12hr

Dosage Modifications

Renal impairment (capsules/oral solution)

 CrCl 30-60 mL/min

o Decrease dose by 50% divided BID/TID
 CrCl 15-30 mL/min
o If 150 mg/day in normal renal function: Decrease dose to 25-50 mg/day;
administer qDay or BID
 o If 300 mg/day in normal renal function: Decrease dose to 75 mg/day; administer
qDay or BID
o If 450 mg/day in normal renal function: Decrease dose to 100-150 mg/day;
administer qDay or BID
o If 600 mg/day in normal renal function: Decrease dose to 150 mg/day; administer
qDay or BID
 CrCl <15 mL/min
o If 150 mg/day in normal renal function: Decrease dose to 25 mg/day; qDay
o If 300 mg/day in normal renal function: Decrease dose to 25-50 mg/day; qDay
o If 450 mg/day in normal renal function: Decrease dose to 50-75 mg/day; qDay
o If 600 mg/day in normal renal function: Decrease dose to 75 mg/day; qDay
 Supplemental dosage following hemodialysis
o 25 mg qDay regimen: Take 1 supplemental dose of 25 mg or 50 mg
o 25-50 mg qDay regimen: Take 1 supplemental dose of 50 mg or 75 mg
o 50-75 mg qDay regimen: Take 1 supplemental dose of 75 mg or 100 mg
o 75 mg qDay regimen: Take 1 supplemental dose of 100 mg or 150 mg

Renal impairment (ER tablets)

 CrCl 30-60 mL/min

o If 165 mg/day in normal renal function: Decrease dose to 82.5 mg/day
o If 330 mg/day in normal renal function: Decrease dose to 165 mg/day
o If 495 mg/day in normal renal function: Decrease dose to 247.5 mg/day
o If 660 mg/day in normal renal function: Decrease dose to 330 mg/day
 CrCl <30 mL/min or hemodialysis
o Not recommended
o Patients should only receive capsules or oral solution

Dosing Considerations

Conversion from capsules or oral solution (Lyrica) to ER tablets (Lyrica CR)

 Lyrica total daily dose (TDD) 75 mg/day = Lyrica CR 82.5 mg/day

 Lyrica TDD 150 mg/day = Lyrica CR 165 mg/day
 Lyrica TDD 225 mg/day = Lyrica CR 247.5 mg/day
 Lyrica TDD 300 mg/day = Lyrica CR 330 mg/day (3 × 82.5 mg tablets)
 Lyrica TDD 450 mg/day = Lyrica CR 495 mg/day (3 × 165 mg tablets)
 Lyrica TDD 600 mg/day = Lyrica CR 660 mg/day (2 × 330 mg tablets)

Dosage Forms & Strengths

capsule: Schedule V

 25mg
 50mg
 75mg
  100mg
 150mg
 200mg
 225mg
 300mg

oral solution: Schedule V

 20mg/mL

Partial Onset Seizures

Regular-release capsules and oral solution only

Indicated as adjunctive therapy for treatment of partial onset seizures in patients aged ≥1 month

<1 month: Safety and efficacy not established

≥1 month to <17 years

 11 kg to <30 kg
o Initial: 3.5 mg/kg/day PO divided q8hr (for 1 month to 4 years) or q8-12hr (for ≥4
years)
o Maintenance: Based on clinical response and tolerability, may increase dose in
weekly increments, not to exceed 14 mg/kg/day
 ≥30 kg
o Initial: 2.5 mg/kg/day PO divided q8-12hr
o Maintenance: Based on clinical response and tolerability, may increase dose in
weekly increments up to 10 mg/kg/day (not to exceed 600 mg/day)

≥17 years

 Initial: 150 mg/day PO divided q8-12hr

 Maintenance: Based on clinical response and tolerability, may increase dose in weekly
increments, not to exceed 600 mg/day

Fibromyalgia

Safety and efficacy not established

A 15-week, placebo-controlled trial (n=107) was conducted in pediatric patients with

fibromyalgia aged 12-17 yr with pregabalin (75-450 mg/day)

The primary efficacy endpoint of change from baseline to Week 15 in mean pain intensity
(derived from an 11-point numeric rating scale) showed numerically greater improvement for the
pregabalin-treated patients compared to placebo-treated patients, but did not reach statistical
significance

Dosage Modifications

Renal impairment: Use in children with compromised renal function has not been studied

Next:

Interactions
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Contraindicated (0)

Serious - Use Alternative (15)

 benazepril

benazepril, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 captopril
 captopril, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 enalapril

enalapril, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 everolimus

everolimus, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 fosinopril

fosinopril, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 imidapril

imidapril, pregabalin. Either increases toxicity of the other by pharmacodynamic

synergism. Avoid or Use Alternate Drug. Additive risk of developing angioedema of
face, mouth, and neck, including respiratory compromise.

 lisinopril

lisinopril, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 metoclopramide intranasal

pregabalin, metoclopramide intranasal. Either increases effects of the other by Other (see
comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide
intranasal or interacting drug, depending on importance of drug to patient.

 moexipril
 moexipril, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 perindopril

perindopril, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 quinapril

quinapril, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 ramipril

ramipril, pregabalin. Either increases toxicity of the other by Other (see comment). Avoid
or Use Alternate Drug. Comment: Coadministration results in additive risk of developing
angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 sirolimus

sirolimus, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 temsirolimus

temsirolimus, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.

 trandolapril

trandolapril, pregabalin. Either increases toxicity of the other by Other (see comment).
Avoid or Use Alternate Drug. Comment: Coadministration results in additive risk of
developing angioedema of face, mouth, and neck. Angioedema may result in respiratory
compromise.
Monitor Closely (122)

 alprazolam

pregabalin, alprazolam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 amitriptyline

pregabalin, amitriptyline. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 amobarbital

pregabalin, amobarbital. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 amoxapine

pregabalin, amoxapine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 belladonna and opium

pregabalin, belladonna and opium. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 benzhydrocodone/acetaminophen

pregabalin, benzhydrocodone/acetaminophen. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 brexanolone
 brexanolone, pregabalin. Either increases toxicity of the other by sedation. Use
Caution/Monitor.

pregabalin, brexanolone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 brexpiprazole

pregabalin, brexpiprazole. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 brompheniramine

pregabalin, brompheniramine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 buprenorphine

pregabalin, buprenorphine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 buprenorphine buccal

pregabalin, buprenorphine buccal. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 buprenorphine subdermal implant

pregabalin, buprenorphine subdermal implant. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 buprenorphine transdermal
 pregabalin, buprenorphine transdermal. Either increases effects of the other by
pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 buprenorphine, long-acting injection

pregabalin, buprenorphine, long-acting injection. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 bupropion

pregabalin, bupropion. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 buspirone

pregabalin, buspirone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 butabarbital

pregabalin, butabarbital. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 butalbital

pregabalin, butalbital. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 butorphanol

pregabalin, butorphanol. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.
 carbinoxamine

pregabalin, carbinoxamine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 cenobamate

cenobamate, pregabalin. Either increases effects of the other by sedation. Use

Caution/Monitor.

 cetirizine

pregabalin, cetirizine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 chloral hydrate

pregabalin, chloral hydrate. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 chlordiazepoxide

pregabalin, chlordiazepoxide. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 chlorpheniramine

pregabalin, chlorpheniramine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 citalopram

pregabalin, citalopram. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.
 clemastine

pregabalin, clemastine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 clobazam

pregabalin, clobazam. Either increases effects of the other by Other (see comment).
Modify Therapy/Monitor Closely. Comment: Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

pregabalin, clobazam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 clomipramine

pregabalin, clomipramine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 clonazepam

pregabalin, clonazepam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 clorazepate

pregabalin, clorazepate. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 codeine

pregabalin, codeine. Either increases effects of the other by pharmacodynamic synergism.

Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in
serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and
monitor for respiratory depression and sedation.
 cyproheptadine

pregabalin, cyproheptadine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 desipramine

pregabalin, desipramine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 desloratadine

pregabalin, desloratadine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 desvenlafaxine

pregabalin, desvenlafaxine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 deutetrabenazine

pregabalin and deutetrabenazine both increase sedation. Use Caution/Monitor.

 dexchlorpheniramine

pregabalin, dexchlorpheniramine. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 diazepam

pregabalin, diazepam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.
 diazepam intranasal

pregabalin, diazepam intranasal. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 dimenhydrinate

pregabalin, dimenhydrinate. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 diphenhydramine

pregabalin, diphenhydramine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 doxepin

pregabalin, doxepin. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 doxylamine

pregabalin, doxylamine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 duloxetine

pregabalin, duloxetine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 escitalopram

pregabalin, escitalopram. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
 result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 esketamine intranasal

esketamine intranasal, pregabalin. Either increases toxicity of the other by sedation.

Modify Therapy/Monitor Closely.

pregabalin, esketamine intranasal. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 estazolam

pregabalin, estazolam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 eszopiclone

pregabalin, eszopiclone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 ethanol

pregabalin, ethanol. Either increases effects of the other by pharmacodynamic synergism.

Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in
serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and
monitor for respiratory depression and sedation.

 fentanyl

pregabalin, fentanyl. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 fentanyl intranasal

pregabalin, fentanyl intranasal. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
 result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 fentanyl transdermal

pregabalin, fentanyl transdermal. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 fentanyl transmucosal

pregabalin, fentanyl transmucosal. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 fexofenadine

pregabalin, fexofenadine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 fluoxetine

pregabalin, fluoxetine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 flurazepam

pregabalin, flurazepam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 fluvoxamine

fluvoxamine, pregabalin. Either increases toxicity of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration may result in life-
threatening, and fatal respiratory depression; use lowest dose possible and monitor for
respiratory depression and sedation.

 gepirone
 pregabalin, gepirone. Either increases effects of the other by pharmacodynamic
synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 hydrocodone

pregabalin, hydrocodone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 hydromorphone

pregabalin, hydromorphone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 hydroxyzine

pregabalin, hydroxyzine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 imipramine

pregabalin, imipramine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 isocarboxazid

pregabalin, isocarboxazid. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 lasmiditan

lasmiditan, pregabalin. Either increases effects of the other by sedation. Use

Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs,
including alcohol have not been evaluated in clinical studies. Lasmiditan may cause
sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
 lemborexant

lemborexant, pregabalin. Either increases effects of the other by sedation. Modify

Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is
coadministered with other CNS depressants because of potentially additive effects.

pregabalin, lemborexant. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 levocetirizine

pregabalin, levocetirizine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 levomilnacipran

pregabalin, levomilnacipran. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 levorphanol

pregabalin, levorphanol. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 loratadine

pregabalin, loratadine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 lorazepam

pregabalin, lorazepam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.
 loxicodegol

pregabalin, loxicodegol. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 lumateperone

pregabalin, lumateperone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 lurasidone

lurasidone, pregabalin. Either increases toxicity of the other by Other (see comment). Use
Caution/Monitor. Comment: Potential for increased CNS depressant effects when used
concurrently; monitor for increased adverse effects and toxicity.

 maprotiline

pregabalin, maprotiline. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 meperidine

pregabalin, meperidine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 meprobamate

pregabalin, meprobamate. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 methadone

pregabalin, methadone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
 result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 midazolam

pregabalin, midazolam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 midazolam intranasal

midazolam intranasal, pregabalin. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of
other CNS depressants may increase the risk of hypoventilation, airway obstruction,
desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

pregabalin, midazolam intranasal. Either increases effects of the other by

pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of
CNS depressants can result in serious, life-threatening, and fatal respiratory depression.
Use lowest dose possible and monitor for respiratory depression and sedation.

 milnacipran

pregabalin, milnacipran. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 mirtazapine

pregabalin, mirtazapine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 morphine

pregabalin, morphine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 nalbuphine
 pregabalin, nalbuphine. Either increases effects of the other by pharmacodynamic
synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 nefazodone

pregabalin, nefazodone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 nortriptyline

pregabalin, nortriptyline. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 oliceridine

pregabalin, oliceridine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 orlistat

orlistat decreases levels of pregabalin by inhibition of GI absorption. Applies only to oral

form of both agents. Modify Therapy/Monitor Closely. Risk of convulsions.

 oxazepam

pregabalin, oxazepam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 oxycodone

pregabalin, oxycodone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 oxymorphone
 pregabalin, oxymorphone. Either increases effects of the other by pharmacodynamic
synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 paroxetine

pregabalin, paroxetine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 pentazocine

pregabalin, pentazocine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 pentobarbital

pregabalin, pentobarbital. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 phenelzine

pregabalin, phenelzine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 promethazine

pregabalin, promethazine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 protriptyline

pregabalin, protriptyline. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.
 quazepam

pregabalin, quazepam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 ramelteon

pregabalin, ramelteon. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 remifentanil

pregabalin, remifentanil. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 remimazolam

pregabalin, remimazolam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 samidorphan

pregabalin, samidorphan. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 secobarbital

pregabalin, secobarbital. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 sertraline

pregabalin, sertraline. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
 result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 stiripentol

stiripentol, pregabalin. Either increases effects of the other by sedation. Modify

Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious,
life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor
for respiratory depression and sedation.

 sufentanil

pregabalin, sufentanil. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 sufentanil SL

pregabalin, sufentanil SL. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 suvorexant

pregabalin, suvorexant. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 tapentadol

pregabalin, tapentadol. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 tasimelteon

pregabalin, tasimelteon. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 temazepam
 pregabalin, temazepam. Either increases effects of the other by pharmacodynamic
synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 tramadol

pregabalin, tramadol. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 tranylcypromine

pregabalin, tranylcypromine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 trazodone

pregabalin, trazodone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 triazolam

pregabalin, triazolam. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 trimipramine

pregabalin, trimipramine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 triprolidine

pregabalin, triprolidine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.
  venlafaxine

pregabalin, venlafaxine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 vilazodone

pregabalin, vilazodone. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 vortioxetine

pregabalin, vortioxetine. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 zaleplon

pregabalin, zaleplon. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

 zolpidem

pregabalin, zolpidem. Either increases effects of the other by pharmacodynamic

synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can
result in serious, life-threatening, and fatal respiratory depression. Use lowest dose
possible and monitor for respiratory depression and sedation.

Minor (0)

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Adverse Effects
Dose-dependent; percentages according to highest reported

>10%
Lyrica CR

 Dizziness (3.4-17.1%)
 Somnolence (0.5-11.4%)

Lyrica

 Dizziness (8-45%)
 Somnolence (lethargy, sluggishness, hypersomnia; 4-36%)
 Peripheral edema (16%)
 Ataxia (1-20%)
 Fatigue (5-11%)
 Xerostomia (1-15%)
 Weight gain (16%)
 Tremor (11%)
 Blurred vision (1-12%)
 Diplopia (12%)

1-10%

Lyrica CR

 Vertigo (1-3.9%)
 Headache (1.9-3.9%)
 Vision blurred (0.5-3.7%)
 Balance disorder (0.5-2.6%)
 Weight increased (2.5-3.8%)
 Fatigue (2.4-3.9%)
 Constipation (2.7%)
 Dry mouth (0.5-3.7%)
 Nausea (3-3.4%)
 Peripheral edema (3.8-4.9%)
 Fatigue (1.4 -3.9%)
 Joint swelling (1.9%)
 Nasopharyngitis (1.4-1.5%)
 ALT/AST increased (0.2-1.4%)
 Diarrhea (1-1.4%)

Lyrica

 Asthenia (5%)
 Edema (8%)
 Facial edema (<3%)
 Hypotension (2%)
 Neuropathy (2-9%)
 Pain (5%)
  Disorientation (<2%)
 Constipation (5%)
 Weight gain (4%)
 Accidental injury (4%)
 Abnormal thinking (2%)
 Confusion (<7%)
 Amnesia (<6%)
 Vertigo (1-4%)

<1%

Addiction

Anemia

Diarrhea

Gynecomastia and breast enlargement

Epididymitis

Esophagitis

Dysmenorrhea

Dystonia

Heart failure

Hirsutism

Uveitis

Postmarketing Reports

Angioedema

Suicidal behavior and ideation

Creatinine kinase

Decreased platelet count

Pneumonia

Viral infection
Bullous pemphigoid

Respiratory depression

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Warnings
Contraindications

Hypersensitivity

Cautions

Peripheral edema may occur; higher frequencies of weight gain and peripheral edema were
observed in patients taking both pregabalin and a thiazolidinedione antidiabetic agent compared
to patients taking either drug alone; monitor these patients for possible exacerbation of
congestive heart failure symptoms when using pregabalin

Pregabalin may cause dizziness and somnolence; inform patients that pregabalin may impair
their ability to perform tasks such as driving or operating machinery; concomitant use of
pregabalin with other central nervous system (CNS) depressants may exacerbate these effects;
for patients 1 month to less than 4 years of age, somnolence includes related terms lethargy,
sluggishness, and hypersomnia

Weight gain may occur; long-term cardiovascular effects of pregabalin-associated weight gain
are unknown

Symptoms including, insomnia, nausea, headache, anxiety, and diarrhea were reported following
abrupt or rapid discontinuation of treatment; increased seizure frequency may occur in patients
with seizure disorders and have rapid discontinued treatment; taper pregabalin gradually over a
minimum of 1 week rather than discontinuing the drug abruptly

Unexpectedly high incidence of hemangiosarcoma was identified in 2 different strains of mice;

the clinical significance of this finding is unknown

In controlled studies, blurred vision and other vision-related events were reported with treatment;
clinical significance of the ophthalmologic findings is unknown, inform patients to notify their
physician if changes in vision occur; if visual disturbance persists, consider further assessment

Creatine kinase elevations has been associated with treatment; monitor for symptoms (eg,
unexplained muscle pain, tenderness, or weakness, particularly if these muscle symptoms are
accompanied by malaise or fever); discontinue treatment if myopathy is diagnosed or suspected
or if markedly elevated creatine kinase levels occur
Serious, life-threatening, or fatal respiratory depression reported when coadministered with
central nervous system depressants, including opioids, or in the setting of underlying respiratory
impairment; consider initiating therapy at low dose and monitor for symptoms of respiratory
depression and sedation if co-prescribing of another CNS depressant, like opioid, or prescribing
to patients with underlying respiratory impairment

Monitor for decreased platelet count (rare)

May cause prolongation of PR interval

Suicidal thoughts or behaviors

 Antiepileptic drugs increase risk of suicidal thoughts or behavior in patients taking these
drugs for any indication; monitor for emergence or worsening of depression, suicidal
thoughts or behavior, and/or any unusual changes in mood or behavior
 Inform patients, their caregivers, and families of the increase the risk of suicidal thoughts
and behavior; advise to be alert for the emergence or worsening of signs and symptoms

Angioedema

 Angioedema of the face, extremities, lips, tongue, glottis, and larynx has been reported
during initial and chronic treatment, including reports of life-threatening angioedema
with respiratory compromise requiring emergency intervention
 If laryngeal stridor or angioedema of the face, tongue, or glottis occurs, discontinue
therapy and institute appropriate therapy immediately
 Coadministration of ACE inhibitors or mTOR (mammalian target of rapamycin)
inhibitors (eg, temsirolimus, sirolimus, everolimus), or previous history of angioedema
may increase risk

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Pregnancy & Lactation

Pregnancy

There are no adequate and well-controlled studies with pregabalin in pregnant women

Animal data

 In the animal fertility study with pregabalin in male rats, adverse reproductive and
developmental effects were observed
 In animal reproduction studies, increased incidences of fetal structural abnormalities and
other manifestations of developmental toxicity, including skeletal malformations,
retarded ossification, and decreased fetal body weight were observed in the offspring of
rats and rabbits given pregabalin orally during organogenesis, at doses that produced
 plasma pregabalin exposures (AUC) greater than or equal to 16 times human exposure at
the maximum recommended dose (MRD) of 600 mg/day

Pregnancy Registry

 Monitors pregnancy outcomes in women exposed to pregabalin during pregnancy

 Enroll pregnant patients in the North American Antiepileptic Drug (NAAED) Pregnancy
Registry; contact 1-888-233-2334 or find more information at
http://www.aedpregnancyregistry.org/

Lactation

Small amounts of pregabalin have been detected in the milk of lactating women

Based on animal studies, there is a potential risk of tumorigenicity with pregabalin exposure via
breast milk to the breastfed infant

Available clinical study data in patients greater than 12 years of age do not provide a clear
conclusion about the potential risk of tumorigenicity with pregabalin

Because of the potential risk of tumorigenicity, breastfeeding is not recommended during

treatment

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or
animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not
available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence
of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
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Pharmacology
Mechanism of Action

Precise mechanism of action unknown but is a GABA analogue that binds to a subunit of
voltage-gated calcium channels in CNS; does not affect sodium channels, opiate receptors, or
cyclo-oxygenase enzyme activity; interactions with descending noradrenergic and serotonergic
pathways originating from the brain stem appear to reduce neuropathic pain transmission from
spinal cord

Absorption

Bioavailability: >90%

AUC (24 hr): 31.5 mcg·h/mL (75 mg capsule BID); 29.4 mcg·h/mL (165 mg ER tablet)

Peak plasma concentration: 3.2 mcg/mL (75 mg capsule BID); 2 mcg/mL (165 mg ER tablet)

Peak plasma time, fasting: 1.5 hr (capsule)

Peak plasma time, with food: 3 hr (ER tablet)

Steady-state is achieved within 24-48 hr

Distribution

Vd: 0.5 L/kg

Protein bound: None

Although there are no data in humans, pregabalin has been shown to cross the blood brain barrier
in mice, rats, and monkeys

Metabolism

Minimal

Elimination

Half-life: 6.3 hr

Clearance: 67-80.9 mL/min

Excretion: Urine

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Administration
Oral Administration
Capsules/oral solution

 Take orally with or without food

 When discontinuing treatment, taper gradually over a minimum of 1 week

ER tablets

 Take once daily after an evening meal

 Swallow whole and should not be split, crushed, or chewed
 When discontinuing treatment, taper gradually over a minimum of 1 week
 Missed dose after an evening meal, then take usual dose prior to bedtime following a
snack
 Missed dose prior to bedtime, then take usual dose following a morning meal
 Missed dose following the morning meal, then take usual dose at the usual time that
evening following an evening meal

Storage

Store at 20-25°C (68-77°F), excursions permitted between 15-30°C (between 59-86°F) in the
original package

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Images
BRAND FORM. UNIT PRICEPILL IMAGE
Lyrica oral
25 mg capsule
-
Lyrica oral
150 mg capsule
-
Lyrica oral
300 mg capsule
-
Lyrica oral
50 mg capsule
-
Lyrica oral
75 mg capsule
-
Lyrica oral
100 mg capsule
-
Lyrica oral
200 mg capsule
-
Lyrica oral
225 mg capsule
-
Lyrica oral
20 mg/mL solution
-
 BRAND FORM. UNIT PRICEPILL IMAGE
pregabalin oral
225 mg capsule
-
pregabalin oral
25 mg capsule
-
pregabalin oral
150 mg capsule
-
pregabalin oral
75 mg capsule
-
pregabalin oral
50 mg capsule
-
pregabalin oral
300 mg capsule
-
pregabalin oral
225 mg capsule
-
pregabalin oral
200 mg capsule
-
pregabalin oral
150 mg capsule
-
pregabalin oral
75 mg capsule
-
pregabalin oral
50 mg capsule
-
pregabalin oral
25 mg capsule
-
pregabalin oral
300 mg capsule
-
pregabalin oral
225 mg capsule
-
pregabalin oral
200 mg capsule
-
pregabalin oral
150 mg capsule
-
pregabalin oral
100 mg capsule
-
pregabalin oral
300 mg capsule
-
pregabalin oral
225 mg capsule
-
pregabalin oral
200 mg capsule
-
pregabalin oral
150 mg capsule
-
pregabalin oral
100 mg capsule
-
pregabalin oral75 mg capsule
 BRAND FORM. UNIT PRICEPILL IMAGE
-
pregabalin oral
50 mg capsule
-
pregabalin oral
25 mg capsule
-
pregabalin oral
100 mg capsule
-
pregabalin oral
300 mg capsule
-
pregabalin oral
200 mg capsule
-
pregabalin oral
150 mg capsule
-
pregabalin oral
100 mg capsule
-
pregabalin oral
50 mg capsule
-
pregabalin oral
25 mg capsule
-
pregabalin oral
75 mg capsule
-
pregabalin oral
75 mg capsule
-
pregabalin oral
50 mg capsule
-
pregabalin oral
25 mg capsule
-
pregabalin oral
150 mg capsule
-
pregabalin oral
200 mg capsule
-
pregabalin oral
100 mg capsule
-
pregabalin oral
75 mg capsule
-
pregabalin oral
50 mg capsule
-
pregabalin oral
300 mg capsule
-
pregabalin oral
150 mg capsule
-
pregabalin oral
75 mg capsule
-
pregabalin oral
25 mg capsule
-
 BRAND FORM. UNIT PRICEPILL IMAGE
pregabalin oral
100 mg capsule
-
pregabalin oral
200 mg capsule
-
pregabalin oral
225 mg capsule
-
pregabalin oral
225 mg capsule
-
pregabalin oral
150 mg capsule
-
pregabalin oral
300 mg capsule
-
pregabalin oral
100 mg capsule
-
pregabalin oral
50 mg capsule
-
pregabalin oral
25 mg capsule
-
pregabalin oral
200 mg capsule
-
pregabalin oral
25 mg capsule
-
pregabalin oral
225 mg capsule
-
pregabalin oral
300 mg capsule
-
pregabalin oral
300 mg capsule
-
pregabalin oral
150 mg capsule
-
pregabalin oral
50 mg capsule
-
pregabalin oral
225 mg capsule
-
pregabalin oral
200 mg capsule
-
pregabalin oral
100 mg capsule
-
pregabalin oral
75 mg capsule
-
pregabalin oral
200 mg capsule
-
pregabalin oral
300 mg capsule
-
pregabalin oral150 mg capsule
 BRAND FORM. UNIT PRICEPILL IMAGE
-
pregabalin oral
75 mg capsule
-
pregabalin oral
100 mg capsule
-
pregabalin oral
25 mg capsule
-
pregabalin oral
225 mg capsule
-
pregabalin oral
200 mg capsule
-
pregabalin oral
300 mg capsule
-
pregabalin oral
50 mg capsule
-
pregabalin oral
75 mg capsule
-
pregabalin oral
100 mg capsule
-
pregabalin oral
50 mg capsule
-

Copyright © 2010 First DataBank, Inc.

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Patient Handout
Print
Patient Education
pregabalin oral

PREGABALIN EXTENDED-RELEASE - ORAL

(pree-GAB-a-lin)

COMMON BRAND NAME(S): Lyrica CR

USES: This medication is used to treat pain caused by nerve damage due to diabetes or shingles
(herpes zoster) infection.

HOW TO USE: Read the Medication Guide provided by your pharmacist before you start taking
pregabalin and each time you get a refill. If you have any questions, ask your doctor or
pharmacist.Take this medication by mouth as directed by your doctor, usually once daily after an
evening meal. Swallow the tablets whole. Do not split, crush, or chew. Doing so can release all
of the drug at once, increasing the risk of side effects.The dosage is based on your medical
condition and response to treatment. To reduce your risk of side effects (such as dizziness and
drowsiness), your doctor may direct you to start this medication at a low dose and gradually
increase your dose. Follow your doctor's instructions carefully.Use this medication regularly to
get the most benefit from it. To help you remember, take it at the same time each day.Do not stop
taking this medication without consulting your doctor. Some conditions may become worse
when this drug is suddenly stopped. Also, you may experience symptoms such as difficulty
sleeping, nausea, headache, and diarrhea. To prevent these symptoms while you are stopping
treatment with this drug, your doctor may reduce your dose gradually. Report any new or
worsening symptoms right away.Though it helps many people, this medication may sometimes
cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of
or addiction to drugs/alcohol). Take this medication exactly as prescribed to lower the risk of
addiction. Ask your doctor or pharmacist for more details.Tell your doctor if your condition lasts
or gets worse.

SIDE EFFECTS: Drowsiness, dizziness, headache, dry mouth, nausea, constipation, and weight
gain may occur. If any of these effects last or get worse, tell your doctor or pharmacist
promptly.Remember that this medication has been prescribed because your doctor has judged
that the benefit to you is greater than the risk of side effects. Many people using this medication
do not have serious side effects.Tell your doctor right away if you have any serious side effects,
including: vision changes (such as blurred vision), unusual bleeding/bruising, muscle
pain/tenderness/weakness (especially with fever or unusual tiredness), swelling
hands/ankles/feet.A small number of people who take anticonvulsants for any condition (such as
seizure, bipolar disorder, pain) may experience depression, suicidal thoughts/attempts, or other
mental/mood problems. Tell your doctor right away if you or your family/caregiver notice any
unusual/sudden changes in your mood, thoughts, or behavior such as signs of depression,
suicidal thoughts/attempts, thoughts about harming yourself.Get medical help right away if you
have any very serious side effects, including: slow/shallow breathing.A very serious allergic
reaction to this drug is rare. However, get medical help right away if you notice any symptoms of
a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat),
severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you
notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your
doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-
1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side
effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking pregabalin, tell your doctor or pharmacist if you are allergic to
it; or if you have any other allergies. This product may contain inactive ingredients, which can
cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using
this medication, tell your doctor or pharmacist your medical history, especially of: heart
problems (such as heart failure), kidney disease, history of an allergic reaction which included
itching/swelling of the face/lips/tongue/throat (angioedema), personal or family history of a
substance use disorder (such as overuse of or addiction to drugs/alcohol), breathing problems
(such as COPD).This drug may make you dizzy or drowsy or cause blurred vision. Alcohol or
marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do
anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic
beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell
your doctor or dentist about all the products you use (including prescription drugs,
nonprescription drugs, and herbal products).Older adults may be more sensitive to the side
effects of this drug, especially slow/shallow breathing.During pregnancy, this medication should
be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug
passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase
your risk for serious side effects. This document does not contain all possible drug interactions.
Keep a list of all the products you use (including prescription/nonprescription drugs and herbal
products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage
of any medicines without your doctor's approval.A product that may interact with this drug is:
orlistat.The risk of serious side effects (such as slow/shallow breathing, severe
drowsiness/dizziness) may be increased if this medication is taken with other products that may
also cause drowsiness or breathing problems. Tell your doctor or pharmacist if you are using
other products such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol,
marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem),
muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine,
diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold
products) because they may contain ingredients that cause drowsiness. Ask your pharmacist
about using those products safely.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or
trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can
call their local poison control center at 1-800-222-1222. Canada residents can call a provincial
poison control center.

NOTES: Do not share this medication with others. Sharing it is against the law.Lab and/or
medical tests (such as kidney function, platelet count) may be done while you are taking this
medication. Keep all medical and lab appointments. Consult your doctor for more details.

MISSED DOSE: If you miss a dose and remember before bedtime, take it after a snack before
bedtime. If it is the next morning when you remember, take the dose after the morning meal. If
you remember after the morning, skip the missed dose. Take your next dose at the regular time.
Do not double the dose to catch up.

STORAGE: Store at room temperature away from light and moisture. Do not store in the
bathroom. Keep all medications away from children and pets.Do not flush medications down the
toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is
expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have
all possible information about this product. This information does not assure that this product is
safe, effective, or appropriate for you. This information is not individual medical advice and does
not substitute for the advice of your health care professional. Always ask your health care
professional for complete information about this product and your specific health needs.

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Formulary
FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be
edited at any time.

Create Your List of Plans

Adding plans allows you to:

 View the formulary and any restrictions for each plan.

 Manage and view all your plans together – even plans in different states.
 Compare formulary status to other drugs in the same class.
 Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes
only. Individual plans may vary and formulary information changes. Contact the
applicable plan provider for the most current information.

View explanations for tiers and restrictions

Tie
Description
r
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on
2
formulary) brand drugs.
This drug is available at a higher level co-pay. Most commonly, these are "non-preferred"
3
brand drugs.
This drug is available at a higher level co-pay. Most commonly, these are "non-preferred"
4
brand drugs or specialty prescription products.
This drug is available at a higher level co-pay. Most commonly, these are "non-preferred"
5
brand drugs or specialty prescription products.
This drug is available at a higher level co-pay. Most commonly, these are "non-preferred"
6
brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Cod Definition
 e
Prior Authorization
PA Drugs that require prior authorization. This restriction requires that specific clinical criteria
be met prior to the approval of the prescription.
Quantity Limits
QL Drugs that have quantity limits associated with each prescription. This restriction typically
limits the quantity of the drug that will be covered.
Step Therapy
ST Drugs that have step therapy associated with each prescription. This restriction typically
requires that certain criteria be met prior to approval for the prescription.
Other Restrictions
OR Drugs that have restrictions other than prior authorization, quantity limits, and step therapy
associated with each prescription.