pregabalin (Rx)

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

Renal impairment (ER tablets)

  • CrCl 30-60 mL/min
    • If 165 mg/day in normal renal function: Decrease dose to 82.5 mg/day
    • If 330 mg/day in normal renal function: Decrease dose to 165 mg/day
    • If 495 mg/day in normal renal function: Decrease dose to 247.5 mg/day
    • If 660 mg/day in normal renal function: Decrease dose to 330 mg/day
  • CrCl <30 mL/min or hemodialysis
    • Not recommended
    • 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
    • Initial: 3.5 mg/kg/day PO divided q8hr (for 1 month to 4 years) or q8-12hr (for ≥4 years)
    • Maintenance: Based on clinical response and tolerability, may increase dose in weekly increments, not to exceed 14 mg/kg/day
  • ≥30 kg
    • Initial: 2.5 mg/kg/day PO divided q8-12hr
    • 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

Interaction Checker

and pregabalin

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              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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                pregabalin oral
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                pregabalin oral
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                150 mg capsule
                pregabalin oral
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                75 mg capsule
                pregabalin oral
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                100 mg capsule
                pregabalin oral
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                200 mg capsule
                pregabalin oral
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                25 mg capsule
                pregabalin oral
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                300 mg capsule
                pregabalin oral
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                225 mg capsule
                pregabalin oral
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                50 mg capsule
                pregabalin oral
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                50 mg capsule
                pregabalin oral
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                150 mg capsule
                pregabalin oral
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                300 mg capsule
                pregabalin oral
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                150 mg capsule
                pregabalin oral
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                100 mg capsule
                pregabalin oral
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                25 mg capsule
                pregabalin oral
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                300 mg capsule
                pregabalin oral
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                50 mg capsule
                pregabalin oral
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                100 mg capsule
                pregabalin oral
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                25 mg capsule
                pregabalin oral
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                75 mg capsule
                Lyrica oral
                -
                300 mg capsule
                Lyrica oral
                -
                25 mg capsule
                Lyrica oral
                -
                150 mg capsule
                Lyrica oral
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                50 mg capsule
                Lyrica oral
                -
                75 mg capsule
                Lyrica oral
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                100 mg capsule
                Lyrica oral
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                200 mg capsule
                Lyrica oral
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                225 mg capsule
                Lyrica oral
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                20 mg/mL solution

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                pregabalin oral

                PREGABALIN - ORAL

                (pree-GAH-ba-lin)

                COMMON BRAND NAME(S): Lyrica

                USES: This medication is used to treat pain caused by nerve damage due to diabetes, shingles (herpes zoster) infection, or spinal cord injury. This medication is also used to treat pain in people with fibromyalgia.It is also used with other medications to treat certain types of seizures (focal seizures).

                HOW TO USE: Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using pregabalin and each time you get a refill. If you have any questions regarding the information, consult your doctor or pharmacist.Take this medication by mouth as directed by your doctor, usually 2 to 3 times a day with or without food. The dosage is based on your medical condition, kidney function, and response to treatment. Children's dosage is also based on weight.If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.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 times each day. This drug works best when the amount of medicine in your body is kept at a constant level. It is best to take pregabalin at evenly spaced intervals throughout the day and night.Do not stop taking this medication without consulting your doctor. Some conditions (such as seizures) 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 persists or worsens.

                SIDE EFFECTS: Drowsiness, dizziness, dry mouth, constipation, difficulty concentrating, or weight gain may occur. If any of these effects persist or worsen, 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 unlikely but serious side effects, including: blurred vision, unusual bleeding/bruising, unsteadiness, confusion, muscle pain/tenderness/weakness (especially if you are tired or have a fever), swelling of hands/legs/feet, signs of kidney problems (such as change in the amount of urine).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 including 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 blur your 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 drowsiness, dizziness, unsteadiness, confusion, and 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.Laboratory tests may be done to measure kidney function.

                MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use 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.

                MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

                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.

                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.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.