Lyrica

What is Lyrica?

Lyrica (pregabalin) is part of a group of drugs known as antiepileptics that slow down the brain impulses responsible for certain types of seizures. This medication also affects the release of specific neurotransmitters, brain chemicals responsible for sending neuropathic pain signals.¹

If your doctor has prescribed Lyrica for you, it's because they decided the medication can play a key role in the healing or maintenance of your particular medical condition.

What is Lyrica used to treat?

Lyrica is approved by the US Food and Drug Administration (FDA) to treat the pain associated with nerve damage resulting from the following conditions:²

• Peripheral neuropathy from diabetes

• Fibromyalgia (immediate-release form only)³

• Shingles (postherpetic neuralgia)

• Spinal cord injuries

Neuropathic pain is typically characterized by a feeling of pins and needles, an electrical shock, burning, a stronger pain reaction than expected to a light touch, or pain that results from damage to the nervous system.⁴ ⁵

Lyrica is also approved for use alongside other medications to treat certain seizure disorders, such as focal-onset (partial-onset) seizures, in adults and children one month of age and older.⁶

Doctors may also prescribe Lyrica off-label for diagnoses such as bipolar disorder, anxiety disorders, restless leg syndrome, and certain other chronic pain conditions.⁷

Dosage forms and strengths

Lyrica is available in immediate-release capsule and liquid forms and as an extended-release tablet.⁸ ⁹

Lyrica immediate-release capsules are available in the following strengths:

• 25mg

• 50mg

• 75mg

• 100mg

• 150mg

• 200mg

• 225mg

• 300mg

The immediate-release oral solution is available in a single strength of 20mg/mL.

And Lyrica CR extended-release tablets are available in the following three strengths:

• 82.5mg

• 165mg

• 330mg

Typically, the recommended adult dose for both immediate-release forms of Lyrica is 150mg daily, divided into two or three doses. Doctors may start with a lower amount and then increase it as needed up to the maximum dose of 600mg per day.

Adults taking the extended-release form, which is indicated exclusively for nerve pain associated with diabetic peripheral neuropathy or shingles, will typically start with one dose of 165mg daily. If this amount doesn’t provide adequate relief, the prescribing physician may increase the dose to 330mg per day (for nerve pain from diabetic peripheral neuropathy) or 660mg per day (for nerve pain from shingles).

Dosing for children is based on the child's weight. The extended-release form of Lyrica has not been adequately studied for safety and efficacy in pediatric patients, so children taking the drug will take one of the immediate-release forms.

Your doctor will decide the best dosing regimen for your age and particular medical condition.

How do you take Lyrica?

Before taking Lyrica and after every refill, read the patient information accompanying your medication. If you have questions about the instructions, speak with your doctor or pharmacist.

To begin taking Lyrica, follow your doctor's instructions, which should be listed on the bottle or box containing your medication.

For the capsule form, take the pills by mouth, with or without food. The capsules should be swallowed whole unless otherwise instructed by your doctor.¹⁰

The liquid form of Lyrica must be measured with a dosing syringe or a special dosing spoon provided with your medication. If your pharmacist didn't provide a measuring device, ask them to give you one. To avoid inaccurate measurements, don't use regular flatware spoons to measure your dose.

People taking the extended-release tablet form will take it at the same time each day, after the evening meal. The tablets are specifically designed to deliver the medication gradually over time, so they must not be split, crushed, or chewed.¹¹

For all forms of Lyrica, take your doses in evenly spaced intervals at about the same time each day.

Seeing results

If you've been taking Lyrica as prescribed, you can expect a reduction in your pain levels anywhere from right away to several weeks. In a review of relevant literature, one researcher found it took participants 5–7 days to reach the effective dose.¹²

Who should not take Lyrica?

If you know you're allergic to pregabalin or a similar medication, you shouldn't attempt to take Lyrica.¹³

Additionally, you must let your doctor know if you have any of the following health conditions:¹⁴

• Breathing difficulties, lung disease (especially chronic obstructive pulmonary disease (COPD))

• Mood disorder, including depression or suicidal thoughts

• Bleeding disorder or low platelet levels

• Heart disease (especially congestive heart failure)

• Alcohol or drug use disorder

• Kidney disease (and let them know if you’re on dialysis)

• Seizure disorder (Lyrica may interact with your other medications)

• Diabetes (unless you're being treated for diabetic peripheral neuropathy) 

Potential side effects of Lyrica

Lyrica is generally well-tolerated, but side effects have been reported during clinical trials. In most cases, side effects are mild-to-moderate and resolve without intervention within 2–4 weeks. Until you know how Lyrica affects you, you should avoid operating a vehicle and engaging in other potentially dangerous activities. If you experience any severe or persistent side effects, you should contact your physician.¹⁵ ¹⁶

Common side effects include the following:¹⁷

• Drowsiness

• Dizziness

• Dry mouth

• Weight gain

• Constipation

• Difficulty concentrating

• Abdominal pain

• Fever

• Joint or muscle pain 

• Leg cramps

• Tremor

• Anxiety

• Low sexual desire

• Ringing in the ears

• Blurred vision

• Urinary frequency or incontinence

• Swelling

• Weakness

Some people experience severe side effects while taking Lyrica, including the following:

• Blue-colored lips, fingers, skin, or toes

• Shallow, weak breathing

• Blurred vision

• Confusion

• Extreme muscle weakness

• Low platelete count

• Abnormal heart rhythms, heart failure

• Thoughts about suicide or harming others

Rarely reported side effects include the following:

• Depression

• Mood changes

• Anemia, low platelets

• Visual changes

• Spasms

• Hoarseness

• Increased body hair

• Diarrhea

• Joint swelling

• Vertigo

• Menstrual pain

These lists of potential side effects are not exhaustive. When taken correctly, Lyrica is generally safe and effective. However, if you experience anything unusual while taking Lyrica, speak with your doctor. If you experience any severe or rare side effects, seek immediate medical attention or call 911.

Overdose

As with other medications, it's possible to overdose on Lyrica. If you or someone else has overdosed, go to the nearest emergency department, call the National Poison Control helpline at 1-800-222-1222, or call 911.

Symptoms of an overdose may include any of the following:¹⁸

• Having trouble breathing

• Passing out

• Seizures

• Extreme confusion or depression

• Heart palpitations

• Severe anxiety/restlessness

Allergy information

Lyrica is known to trigger allergic reactions in some people. You may be allergic to a drug if you experience one or more of the following:¹⁹ ²⁰

• Hives, blistering of the skin

• Itching, rash

• Difficulty breathing, wheezing

• Vomiting

• Swelling of the lips, tongue, face, or throat (angioedema)

• Loss of consciousness

If you experience any of the above symptoms, go to the nearest emergency room or call 911.

Long-term use of Lyrica

It’s not uncommon for physicians to prescribe Lyrica for their patients for an extended period (more than a year). If you have been taking Lyrica for a long time and are concerned about some of its side effects or the medication doesn’t seem to be working, you should speak with your physician.

In a study following patients with postherpetic neuralgia across a 52-week period, one team of researchers noted that no new adverse effects were observed with long-term use of the drug.²¹

Lyrica in pregnancy and breastfeeding

Lyrica and pregnancy

The US FDA designated Lyrica as a pregnancy category C drug, meaning risk cannot be ruled out, and the medication may cause fetal harm.²²

There are no satisfactory studies in pregnant women, but animal studies demonstrated a risk to the fetus. However, the potential benefits of the drug may outweigh the risks.²³

Lyrica and breastfeeding

Small amounts of Lyrica have been found in breast milk. There are no adequate studies in humans, but based on the results of animal studies, there may be a risk of tumor formation in infants exposed to Lyrica through breast milk.²⁴

Missed doses

If you miss a dose of any medication, you can always contact your pharmacist or your physician for advice. In general, if you’re taking an immediate-release form, it’s best to take it as soon as you remember. However, if it’s closer in time to your next dose than your missed one, skip the missed dose and take the next one as scheduled. Never double your dose to make up for a missed one.

If you forget to take a Lyrica extended-release tablet after your evening meal, take it before bed after eating a snack. If you don’t remember until morning, you can take your missed dose after breakfast. However, if you remember later, skip the missed dose and resume your regular schedule at your evening meal.²⁵

Drug interactions

Before taking Lyrica, tell your doctor about any medications you're taking, whether they're prescribed or available over the counter. On the list of medications you’ll provide your doctor, include all herbs and supplements you take.

If you're currently taking Lyrica, check with your doctor before starting any of the following:²⁶

• Orlistat

• Muscle relaxers

• Sedatives

• Opioids (morphine, Ultram)

• Drugs for anxiety (Xanax)

• Medications for insomnia (Rozerem, Sonata, Ambien)

• Antihistamines (Benadryl)

• Decongestants (Sudafed)

• Headache medicines containing barbiturates (Fioricet)

• Cannabis (marijuana)

• Alcohol

• Cough relievers such as codeine

• Over-the-counter medicines that cause drowsiness (melatonin)

• Certain diabetes medications (Avandia, Actos)

• ACE inhibitors for high blood pressure (Lotensin, captopril)

• Antidepressants (Elavil, trazodone)

• Anti-psychotics (Abilify, Zyprexa)

• Anti-seizure drugs (Fycompa, phenobarbital, Topamax)

• Medicines that make you sleepy (as a side effect)

• Anti-Parkinson’s medicines (Sinemet)

This list highlights some of the more common interactions, but the information is not complete. Speak with your doctor before taking any medications concurrently.

Is it safe to drink alcohol while taking Lyrica?

Avoid drinking alcohol while taking Lyrica, as combining the two can increase the intensity of side effects such as drowsiness, dizziness, and confusion.

What to discuss with your doctor before starting Lyrica

Lyrica is available by prescription only, so you’ll need to meet with your doctor before you start taking it. At your appointment, tell your doctor if you:

• Are pregnant or planning to become pregnant, or if you're breastfeeding

• Have COPD or other lung conditions

• Take other medications (prescription and non-prescription), herbs, or supplements (regularly or occasionally)

• Have any allergies

• Have heart issues or bleeding problems

• Have a history of depression or thoughts of self-harm

• Have kidney disease

• Have diabetes

• Drink alcohol, use drugs, or have a history of substance use disorder

Stopping Lyrica

If you abruptly discontinue Lyrica, you may experience severe side effects, such as nausea, headaches, diarrhea, anxiety, sweating, and difficulty sleeping. In addition, if you are taking the drug for epilepsy, suddenly stopping may lead to an increase in the frequency of your seizures. 

Lyrica should be tapered slowly over a minimum of one week when the decision is made to stop using it. If you decide to stop taking Lyrica, ask your doctor how to do it safely.²⁷

Drug approval history

• 2004: The US FDA approved Lyrica for neuropathic pain resulting from diabetes or postherpetic neuralgia²⁸

• 2005: Lyrica was approved as an adjunctive treatment for partial-onset seizures²⁹

• 2007: Lyrica became the first drug approved for the treatment of fibromyalgia³⁰

• 2017: The US FDA approved the first extended-release formulation of Lyrica³¹

Tips for taking Lyrica

• Try to take your doses at about the same time every day.

• Don't drive or engage in activities requiring alertness until you know how you'll react to taking Lyrica.

• This medication may be taken with or without food.

• Swallow the capsules and tablets whole unless otherwise instructed by your doctor.

• Pay attention to any changes in your body or mood once you start taking Lyrica, and let your doctor know if you notice anything unusual.

• Don’t stop taking Lyrica abruptly without guidance from your doctor.

• Don’t hesitate to ask your doctor or pharmacist for advice about Lyrica or other medications.