Pregabalin: A drug for many ailments, but is it safe?

Anticonvulsants Prescription medicines Medication safety Medicine Elementary

The bottom line

Pregabalin is used for nerve pain, fibromyalgia, anxiety, and partial-onset seizures. Common side effects are drowsiness, dizziness, poor concentration, confusion, memory problems, unsteadiness, tremors, dry mouth, constipation, nausea, and vomiting. It is a schedule V in the US due to risk of abuse and physical dependence. Avoid central nervous system depressants, such as alcohol, that increase sedation risk.

Prevention Tips

Store pregabalin up, away, and out of reach of children.
Take as prescribed.
Do not take more than prescribed or more often than prescribed.
Do not double your doses if you miss a dose.
Store at room temperature, away from heat and moisture. Do not put in direct sunlight.
Check for drug interactions online or talk to your doctor or pharmacist.
Contact your doctor immediately if you develop hives, skin rash, swelling, blurred vision, difficulty breathing, muscle pain or weakness, or increased heart rate.
Take another drug if pregnant or planning a pregnancy.
Do not stop this medication suddenly since that may cause withdrawal symptoms and seizures.

This Really Happened

A 54-year-old man ingested an overdose (8.4 grams) of pregabalin less than 1 hour before presentation to the emergency department. Past medical history included HIV, HIV-related peripheral neuropathy, and type 2 diabetes. He was alert with normal vital signs, normal renal function, and mild pre-existing liver dysfunction. He was given a dose of activated charcoal and observed. Three hours after ingestion he became unresponsive. He was intubated and mechanically ventilated. Cardiovascular status remained stable and his level of consciousness improved over the next 24 hours. He was extubated. He was treated with antibiotics for aspiration pneumonia. He improved clinically and signed out against medical advice. After his discharge it was determined that blood samples from approximately 3 hours after ingestion had a very high pregabalin level.

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What pregabalin prescribed for?

Pregabalin is prescribed for nerve pain (such as diabetic neuropathy or pain after shingles), fibromyalgia, chronic anxiety, and as an add-on treatment for partial-onset seizures. Its brand name is Lyrica, which is available as capsules, controlled release tablets and oral solution. Generic formulations are also available.

How does pregabalin work?

Pregabalin decreases abnormal brain electrical activity. It also reduces pain messages in the brain.

What are the side effects of pregabalin?

The most common side effects are drowsiness, dizziness, poor concentration, confusion, memory problems, unsteadiness, tremors, dry mouth, constipation, nausea, and vomiting. Older adults may have an increased risk of falls. Other effects include weight gain due to increased appetite and fluid retention in hands and feet. More serious side effects include allergic reactions, blurred vision, difficulty breathing, muscle pain or weakness, and increased heart rate. Pregabalin can also cause anxiety and depression with suicidal thoughts.

Is pregabalin a controlled substance?

Yes, pregabalin is a schedule V drug in the US due to the risk of abuse and physical dependence.

What should I avoid while taking pregabalin?

Be careful driving or operating machinery until you know if pregabalin makes you sleepy. It is best to avoid alcohol and other central nervous system depressants since they will increase the sedative effects of pregabalin. Before you use other prescription or nonprescription drugs, check for interactions online or check with your doctor or pharmacist.

Do not abruptly stop taking pregabalin since this can result in withdrawal symptoms and seizures. Pregabalin is usually not used in pregnancy since there may be an increased risk of major birth defects if taken in first trimester and withdrawal symptoms in the newborn baby if taken near delivery.

What should I do if someone accidentally takes pregabalin or takes too much pregabalin?

If you accidentally take a dose of pregabalin, it is possible you will experience drowsiness, dizziness confusion, nausea, or dry mouth. If someone takes an overdose of pregabalin, they may experience central nervous system depression, dizziness, headache, confusion, agitation, difficulty walking, seizures, vomiting, or decreased blood pressure.

If someone takes too much pregabalin, or if you have a question about using pregabalin safely, use the webPOISONCONTROL^® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.