Pregabalin

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Sep 07, 2022

Warnings

Pregabalin (Lyrica) Risks, Warnings, and Complications

Pregabalin can cause serious medical problems in some people. Talk to your doctor about other options to treat partial onset seizures or neuropathic pain if you are at a high risk of complications. Some of the risks of pregabalin use include:

SEVERE ALLERGIC REACTION: Taking pregabalin can cause angioedema (swelling of the face, tongue, throat, and lips). This can lead to respiratory compromise (breathing difficulties). Stop pregabalin and get immediate medical help if you develop any swelling in the head and neck, persistent abdominal pain, or other signs and symptoms of a severe allergic reaction such as skin problems (hives, skin rash, itching) or breathing problems (difficulty breathing, wheezing). The risk is higher in people with a history of angioedema and in those taking other medications that can also cause angioedema.
RISK WITH CNS DEPRESSANTS LIKE OPIOIDS: Taking pregabalin with other CNS depressants like opioid painkillers is dangerous because it can lead to respiratory depression (breathing problems). The risk of death from opioid overdose is significantly higher when taking opioids with pregabalin. The risk is also higher in older adults and in people with a history of lung conditions like chronic obstructive pulmonary disease (COPD.
SUICIDAL IDEATION: Rarely, patients receiving pregabalin or other anticonvulsant medications can experience worsening depression and an increased risk of suicidal thoughts or behavior. Tell your healthcare provider right away if you notice any new or worsening symptoms of depression or unusual mood or behavior changes.
DIFFICULTY CONCENTRATING: Pregabalin can make you sleepy and dizzy. This can affect your focus and concentration. These side effects are typically more when you first start pregabalin or if you are taking higher doses. Avoid driving and other activities that require you to be alert until you know how pregabalin affects you. The risk of these side effects is more if you drink alcohol or take other medications that also cause drowsiness.
LIMB SWELLING: Pregabalin can cause swelling of the hands and feet. The risk is higher if you have heart failure or take certain diabetes medications like pioglitazone (Actos). Contact your doctor and discuss other options if the swelling side effects are excessive.
WITHDRAWAL SYMPTOMS: If you suddenly stop taking pregabalin, it can lead to withdrawal symptoms such as new or worsening seizures, nausea, diarrhea, sweating, and headache. Talk to your doctor before making any changes to your pregabalin dose. Your doctor can tell you how to reduce the dose gradually over one week before stopping it completely.

Precautions Before Starting Pregabalin (Lyrica)

Tell your doctor if you have had an allergic reaction to pregabalin, any of the active or inactive ingredients in pregabalin preparations, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your doctor a complete medical history. Pregabalin may not be right for people with certain health conditions. Tell your doctor if you have had problems with alcoholism, street drug abuse, or prescription medication misuse. Also, tell your doctor if you have a bleeding disorder, psychiatric disorders, problems with swelling, heart failure, lung disease, heart disease, and kidney disease.

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions between pregabalin and your other medicines.

Tell your doctor if you are pregnant, could be pregnant, are planning a pregnancy, or are breastfeeding an infant. It is unclear if pregabalin passes into breast milk.

Precautions During Use of Pregabalin (Lyrica)

Keep all your healthcare appointments while taking pregabalin. Your doctor may want to adjust your dose and monitor you for any adverse reactions.

Tell your doctor if you or your partner becomes pregnant while you’re taking pregabalin. There are reports that pregabalin can cause decreased fertility and birth defects, but these are based on animal studies. Currently, there are not enough clinical studies that demonstrate birth defects in humans.

Let your doctors know that you are on pregabalin before any surgery, including dental procedures.

Pregabalin may make you drowsy and dizzy and affect your concentration. Do not drive, operate machinery, or do other activities that require complete focus until you know how pregabalin affects you.

Alcohol can make side effects like drowsiness worse. Do not drink alcohol while on pregabalin.

Taking pregabalin can cause mental health changes, including suicidal ideation (thinking, planning, or trying to harm or kill yourself). This risk is small, but you should be aware that unexpected mental status changes can occur as early as one week after starting pregabalin. Call your doctor right away if you experience new or worsening mental health symptoms like restlessness, irritability, agitation, panic attacks, anxiety, depression, impulsiveness, sleep problems, aggression, anger, mania, violent behavior, thoughts of harming yourself, withdrawal from family and friends, or other unusual mood or behavior changes. Your family members or caregivers should know to look out for these symptoms so that they can contact your doctor if you are unable to do so yourself.

Pregabalin (Lyrica) Drug Interactions

Concomitant administration of pregabalin with certain other medicines can affect how the medicines work. Possible drug interactions between pregabalin and other medicines can also increase the risk of severe adverse events. Your doctor may change the dose of your medications or monitor you carefully for possible side effects if there are known interactions between pregabalin and your other medicines.

The following medications can have interactions with pregabalin:

Antidepressants
Medications for anxiety such as lorazepam (Ativan)
Opioid pain medications (narcotics) such as oxycodone (OxyContin, in Percocet), hydrocodone (in Vicodin, in Hydrocet), and morphine (Kadian, Avinza, MSIR)
Antihistamines
Angiotensin-converting enzyme (ACE) inhibitors such as lisinopril (Zestril, Prinivil, Zestoretic, in Prinzide), captopril (Capoten, Capozide), benazepril (Lotensin, in Lotrel), enalapril (Vasotec, Lexxel, in Vaseretic), fosinopril (Monopril), moexipril (Univasc, in Uniretic), trandolapril (Mavik, in Tarka), quinapril (Accupril, in Accuretic, Quinaretic), perindopril (Aceon), and ramipril (Altace)
Medications for seizures and psychiatric disorders
Medications used to treat diabetes, such as pioglitazone (Actos, in Duetact) and rosiglitazone (Avandia, Avandamet, in Avandaryl)
Sleeping pills, sedatives, tranquilizers

The above list may not include all the possible interactions of pregabalin. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and over-the-counter medicines.

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