Pregabalin works in different ways:
- in epilepsy it stops seizures by reducing the abnormal electrical activity in the brain
- with nerve pain it blocks pain by interfering with pain messages travelling through the brain and down the spine
- in anxiety it stops your brain from releasing the chemicals that make you feel anxious
Pregabalin is only available on prescription. It comes as capsules or a liquid that you drink.
- Pregabalin is usually taken 2 or 3 times a day. You can take it with or without food.
- You don't have to have epilepsy for pregabalin to help with pain or anxiety.
- It takes at least a few weeks for pregabalin to work.
- The side effects of pregabalin are usually mild and go away by themselves. The most common ones are feeling sleepy, dizziness and headaches.
- Pregabalin is also called by the brand names Lyrica, Alzain, Lecaent and Rewisca.
Who can and can't take pregabalin
Pregabalin is only for adults. Do not give it to children under the age of 18.
Pregabalin isn't suitable for some people:
- Pregabalin capsules contain gelatin so they may not be suitable for vegetarians and vegans.
- Pregabalin liquid contains sodium. If you are on a controlled sodium diet, or your kidneys don't work well, speak to your doctor before taking this liquid.
To make sure pregabalin is safe for you, tell your doctor if you:
- have ever had an allergic reaction to pregabalin or another medicines in the past
- have kidney problems
- have ever abused or been addicted to a medicine
- are trying to become pregnant, are already pregnant or are breastfeeding
How and when to take
Pregabalin is a prescription medicine. It's important to take it as instructed by your doctor.
How much will I take?
The usual dose of pregabalin is between 150mg and 600mg a day split into 2 or 3 separate doses.
If you are taking pregabalin as a liquid, 2.5ml is usually the same as taking a single 50mg capsule.
How to take it
You can take pregabalin with or without food, but it's best to be consistent each day. Try to space your doses evenly through the day.
Swallow pregabalin capsules whole with a drink of water or juice. Do not chew them.
If you are taking pregabalin as a liquid, it will come with a syringe or spoon to measure your dose. If you don't have a syringe or spoon, ask your pharmacist for one.
Will my dose go up or down?
To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few days.
Once you find a dose that suits you, it will usually then stay the same.
How long will I take it for?
If you have epilepsy, it is likely that once your illness is under control you will continue to take pregabalin for many years.
If you are taking pregabalin for nerve pain or anxiety it is likely that once your symptoms have gone you will continue to take it for several months to stop them coming back.
What if I forget to take it?
If you forget a dose, take it as soon as you remember. If it is within 2 hours of the next dose, it is better to leave out the missed dose and take your next dose as normal.
Never take two doses at the same time. Never take an extra dose to make up for a forgotten one.
If you have epilepsy, it's important to take this medicine regularly. Missing doses may trigger a seizure.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
What if I take too much?
Taking too much pregabalin by accident may cause unpleasant side effects. These include feeling sleepy, confused or agitated, seizures, and passing out.
If you can, take the box or leaflet inside the packet plus any remaining medicine with you to the hospital.
Not everyone will get side effects with pregabalin, it seems to be a very safe medicine.
Common side effects
These common side effects may happen in more than 1 in 100 people. They are usually mild and go away by themselves. Keep taking the medicine but tell your doctor if they bother you or don't go away:
- feeling sleepy
- mood changes
- feeling sick
- swollen hands, arms, legs and feet
- blurred vision
- for men, difficulties with getting an erection
- weight gain – because pregabalin can make you feel hungry
If you have diabetes, pregabalin can upset your blood sugar control. Monitor your blood sugar more often for the first few weeks of treatment with pregabalin and adjust your diabetes treatment if you need to. Talk to your doctor or diabetes nurse if you want more advice on what to do.
Serious side effects
Very few people taking pregabalin have serious problems.
Tell a doctor straight away if notice a serious side effect. These are:
- thoughts of harming or killing yourself. A small number of people taking pregabalin have had suicidal thoughts. They can happen after only a week of treatment.
- finding it difficult to breathe
- severe dizziness or passing out
- problems going to the toilet, including blood in your pee, needing to pee more often, or constipation
Serious allergic reaction
In rare cases, it’s possible to have a serious allergic reaction to pregabalin.
A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.
The warning signs of a serious allergic reaction are:
- getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
- tightness in the chest or throat
- having trouble breathing or talking
- unusual hoarseness
- swelling of the mouth, face, lips, tongue, or throat
These are not all the side effects of pregabalin. For a full list see the leaflet inside your medicines packet.
You can report any suspected side effect to the UK safety scheme.
How to cope with side effects
What to do about:
- feeling sleepy, tired or dizzy – as your body gets used to pregabalin, these side effects should wear off. If they don't wear off within a week or two, your doctor may reduce your dose or increase it more slowly. If that doesn't work you may need to switch to a different medicine.
- feeling sick – take pregabalin with or after a meal or snack to ease feelings of sickness. It may also help if you don't eat rich or spicy food.
- diarrhoea and vomiting – have small but frequent sips of water. It may also help to take oral rehydration solutions which you can buy from a pharmacy or supermarket to prevent dehydration. Don't take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor.
- constipation – eat more high-fibre foods such as fresh fruit and vegetables and cereals, and try to drink several glasses of water or other fluid each day. It may also help to exercise more regularly, for example, by going for a daily walk or run.
- weight gain – pregabalin can make you hungrier so it can be quite a challenge to stop yourself putting on weight. Try to eat a healthy balanced diet without increasing your portion sizes. Don't snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets. If you're hungry between meals, eat fruit and vegetables and low-calorie foods. Regular exercise will also help to keep your weight stable.
- a dry mouth – chew sugar-free gum or suck sugar-free sweets.
Pregnancy and breastfeeding
There is no firm evidence that pregabalin is harmful to an unborn baby but for safety you're usually only advised to take it in pregnancy if the benefits outweigh the risks.
If you take pregabalin for epilepsy and become pregnant, do not stop the medicine without talking to your doctor first. It's very important that epilepsy is treated during pregnancy as seizures can harm you and your unborn baby.
If you're trying to get pregnant or have become pregnant, you're routinely recommended to take at least 400mcg of a vitamin called folic acid every day. It helps the unborn baby grow normally.
Pregnant women who take pregabalin are recommended to take a higher dose of folic acid. Your doctor might prescribe a high dose of folic acid (5mg a day) for you to take during the first 12 weeks of pregnancy.
If you take pregabalin around the time of giving birth, your baby may need extra monitoring for a few days after they're born. This is because they may have pregabalin withdrawal symptoms.
Pregabalin and breastfeeding
Tiny amounts of pregabalin can get into breast milk, but it's not clear whether it can harm the baby.
Talk to your doctor, as other drugs might be better while you're breastfeeding.
Cautions with other medicines
Pregabalin can usually be safely mixed with other medicines.
For safety, tell your doctor if you're taking these medicines before your start pregabalin:
- strong painkillers such as morphine
- medicines which make you feel sleepy or dizzy (pregabalin can worsen these side effects)
Mixing pregabalin with herbal remedies and supplements
There are no known problems with taking herbal remedies and supplements with pregabalin.
However, for safety, speak to your pharmacist before taking pregabalin if you routinely take any herbal or alternative remedies.
How does pregabalin work?
Is it safe to take it for a long time?
Should I stick to the same brand of pregabalin?
Can I get addicted to pregabalin?
What happens when I come off pregabalin?
Can I get epilepsy medicines for free?
Are there similar medicines to pregabalin?
Will it affect my contraception?
Will it affect my fertility?
Can I drive or ride a bike?
Can I drink alcohol with it?
Will recreational drugs affect it?