Pregabalin

What is pregabalin?

Pregabalin belongs to a group of medicines that are thought to control pain by working on brain chemicals which send signals to nerves. These chemicals are called gamma-aminobutyric acid or GABA.

Pregabalin may be used alone, or in combination with other medicines, to treat nerve (neuropathic) pain or fibromyalgia. It is also used as an anti-convulsant for epilepsy.

What benefit can you expect from your treatment?

Pregabalin is used to reduce neuropathic (nerve) pain and sensations such as hot, burning, throbbing, shooting, stabbing, sharp, cramping, aching, tingling, numbness, pins and needles pain and for pain that keeps you awake at night.

How is Pregabalin taken?

It is taken by mouth swallowed whole in capsule form.

When should it be taken?

Take this medicine with a full glass of water at the same time each day. It is often taken multiple times throughout the day and can be taken with or without food.

If you miss a dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

What is the dosage?

Pregabalin comes in different strength capsules. The initial dose may be 25 to 75mg a day and increased to the lowest dose possible to control your pain. Usually, doses range from 150mg- 600mg per day given in two or three divided doses.

Can other medicines be taken with Pregabalin?

This medicine may be used alone or with other arthritis medicines including:

• Other Disease Modifying Anti Rheumatic Drugs (DMARDs) such as methotrexate.
• Steroid medicines such as prednisolone or cortisone injections into the joint.
• Anti-inflammatory medicines (NSAIDs) such as naproxen (Naprosyn®) or ibuprofen (Brufen®, Nurofen®).
• Simple pain medicines such as paracetamol.

The absorption of Pregabalin is affected by certain indigestion/antacid mixtures.

Tell your doctor if you are taking any other medicines, including medicines that you buy at the chemist, supermarket or health food shop.

Are there any side effects?

You might experience side effects with your treatment. Tell your doctor if you notice side effects that you think are caused by this medicine. Many side effects disappear when pregabalin treatment is reduced/stopped.

Most common possible side effects

This list includes the more common side effects of pregabalin, they are usually mild and short-lived.

• feeling tired or drowsy
• increase in weight
• dizziness
• constipation
• diarrhoea
• nausea
• headache
• unsteadiness when walking, reduced co-ordination, shaking or tremors
• dry mouth
• blurred or double vision.

Less common or rare possible side effects

Contact your doctor if you suspect one of these adverse reactions:

• unusual changes in mood or behaviour
• signs of new or increased irritability or agitation
• signs of depression
• swelling of the hands, ankles or feet
• enlargement of breasts
• unexplained muscle pain, tenderness and weakness
• passing little to no urine.

Very rare possible side effects

Contact your doctor if you notice any of the following:

• shortness of breath, swelling of the feet and legs, weight increase due to fluid build-up
• irritated red eyes that are sensitive to light
• sudden signs of allergy such as rash, itching or hives, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or difficulty breathing.

What precautions are necessary?

There have been reports of heart failure in some patients when taking pregabalin; these patients were mostly elderly with cardiovascular conditions. Before taking this medicine, you should tell your doctor if you have a history of heart disease.

Blood tests

Blood tests are not routinely required for this medication.

Use with alcohol

The combination of pregabalin and alcohol can cause significant drowsiness if you have just started on this medicine, or the dose has recently been increased. You are advised not to drink alcohol when you first start this medicine and while the dose is being increased. Once you are on a stable dose and the drowsiness caused by the pregabalin stops, you may drink alcohol.

Driving and using machines

Pregabalin may cause dizziness, sleepiness, and decreased concentration. You should not drive, operate complex machinery or engage in other potentially hazardous activities until you know whether this medicine affects your ability to perform these activities

Use in pregnancy and when breastfeeding 

It is important to discuss with your doctor if you are planning a pregnancy or breastfeeding while on pregabalin.

How to store pregabalin

• Store pregabalin in a cool, dry place, away from direct heat and light (e.g., not in the bathroom).
• Keep all medicines out of reach of children.

How long is the treatment continued?

Treatment with Pregabalin is continued indefinitely as long as it is effective and as long as no serious side effects occur.

If you stop Pregabalin treatment for more than a few weeks there is a risk that your condition may worsen. Continue with your treatment unless advised by your doctor or unless side effects develop.

If you have an illness that makes you unwell enough to change plans for the day (e.g. gastroenteritis or fever), it is reasonable to miss the weekly dose until you have recovered.

Are there any side effects?

You might experience side effects with your treatment. Tell your doctor if you are concerned about possible side effects.

A reduction in dose may minimise side effects so that you can continue to take the treatment. Your doctor will advise on any dose changes that are necessary.

Most common possible side effects

This list includes the more common side effects of pregabalin, they are usually mild and short-lived.

• feeling tired or drowsy
• increase in weight
• dizziness
• constipation
• diarrhoea
• nausea
• headache
• unsteadiness when walking, reduced co-ordination, shaking or tremors
• dry mouth
• blurred or double vision.

Less common or rare possible side effects

Contact your doctor if you suspect one of these adverse reaction:

• unusual changes in mood or behaviour
• signs of new or increased irritability or agitation
• signs of depression
• swelling of the hands, ankles or feet
• enlargement of breasts
• unexplained muscle pain, tenderness and weakness
• passing little to no urine.

Very rare possible side effects

Contact your doctor if you notice any of the following:

• shortness of breath, swelling of the feet and legs, weight increase due to fluid build-up
• irritated red eyes that are sensitive to light
• sudden signs of allergy such as rash, itching or hives, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or difficulty breathing.

More information about possible side effects

Information that comes with your Pregabalin medicine describes in detail potential serious side effects that may occur.

Talk to your doctor or pharmacist if you have concerns about any possible side effects.

What precautions are necessary?

There have been reports of heart failure in some patients when taking Lyrica; these patients were mostly elderly with cardiovascular conditions. Before taking this medicine, you should tell your doctor if you have a history of heart disease.

Blood tests

Blood tests are not routinely required for this medication

Use with other medicines

Pregabalin and certain other medicines may influence each other (interaction). When taken with certain other medicines, the side effects seen may be increased for example, the degree of dizziness, sleepiness may be increased if pregabalin is taken together with medicines containing Oxycodone (used as a pain-killer).

Pregabalin may be taken with oral contraceptives.

Use with alcohol

The combination of Pregabalin and alcohol can cause significant drowsiness if you have just started on this medicine or the dose has recently been increased. You are advised not to drink alcohol when you first start this medicine and while the dose is being increased. Once you are on a stable dose and the drowsiness caused by the Pregabalin stops, you may drink alcohol.

Driving and using machines

Pregabalin may cause dizziness, sleepiness and decreased concentration. You should not drive, operate complex machinery or engage in other potentially hazardous activities until you know whether this medicine affects your ability to perform these activities.

How to store Pregabalin

Keep your capsules in the pack until it is time to take them. If you take the capsules out of the pack they may not keep well.

Keep your capsules in a cool dry place where the temperature stays below 25°C. Do not store Pregabalin or any other medicine in the bathroom or near a sink. Do not leave it on a windowsill or in the car on hot days. Heat and dampness can destroy some medicines.

Keep it where children cannot reach it. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

Important things to remember

• You should see your doctor regularly to make sure the treatment is working and check for possible side effects.
• You may need regular blood tests as suggested by your
• It is important to tell your rheumatologist if you have a new serious illness such as a serious infection, cancer or heart failure.
• If you are worried about any side effects, you should contact your rheumatologist as soon as possible.
• If you stop pregabalin for any reason, you must contact your doctor.
• If you plan to become pregnant, you must discuss the timing with your nominated doctor/rheumatologist.

For more information see the Pregabalin- printable information sheet.