Pregabalin (Lyrica®) belongs to a group of medications called analgesics.
What is this medication used for?
Pregabalin is approved by Health Canada for management of nerve pain and fibromyalgia in adults. Pregabalin is not approved by Health Canada for use in children and adolescents.
Evidence shows pregabalin benefits adults with generalized anxiety disorder or social anxiety disorder. Pregabalin is sometimes prescribed for children and adolescents with anxiety who are unable to tolerate or respond to first-line treatments.
When the potential benefits outweigh risks, pregabalin may be prescribed “off-label” for children and adolescents. Learn more about off label use: KMH-off-label
Tell your doctor or pharmacist if you:
- Have allergies or bad reactions to a medication.
- Take or plan to take other prescription or non-prescription medications (including natural medicines). Some medications may interact with pregabalin. Your doctor may adjust doses or monitor for side effects.
- Have a history of severe respiratory problems, liver or kidney disease, heart disease, bowel obstruction, seizures, mood disorders, or head injury.
- Miss a menstrual period, are pregnant, breast-feeding or planning a pregnancy.
- Use alcohol or street drugs. Taking pregabalin with certain substances may cause a bad reaction. Learn more at www.DrugCocktails.ca
When will this medication start to work?
For anxiety, pregabalin is expected to start to reduce symptoms within 1-2 weeks, with full effects expected to be seen in 3-4 weeks. Continue taking this medication even if your symptoms do not improve immediately.
For pain, the effects of pregabalin may be experienced quickly, but full benefit is expected to be seen 3-4 weeks after starting this medication.
Talk with your doctor if you feel that pregabalin has not been helpful or if side effects are too bothersome. Your doctor may recommend switching you to a different dose or medication.
How do I take this medication?
Take this medication as prescribed by your doctor. To help minimize the risk of side effects, your doctor will start you on a low dose, and gradually increase as needed. Typically, pregabalin is taken two or three times daily, with or without food.
Take this medication at the same time every day. Continue taking this medication, even if it has worked to reduce or stop your symptoms of anxiety.
If you are using this medication for pain, continue taking pregabalin on a regular basis to help prevent pain (rather than using it "as needed" for symptoms).
Possible common or serious side effects:
Side effects may be more common when first starting a medication or after a dose increase. Talk to your doctor, nurse, or pharmacist for help managing side effects or if a side effect concerns you.
- Dizziness, weakness or headache
- Drowsiness, difficulty concentrating or trouble sleeping
- Dry mouth, increased thirst
- Increased appetite and weight gain
- Nausea, vomiting, change in bowel pattern, stomach ache
- Swelling of the lower legs or feet
Contact your doctor immediately if you experience:
- Blurry vision, visual field loss or double vision
- Slow, shallow, or weak breathing
- Chest pain, irregular heartbeat
- Unexplained rash, fever, or excessive sweating
- Unusual changes in mood or behaviour such as ongoing sadness or seeing, hearing, or feeling things that are not there
- Thoughts of hurting yourself
- Signs of liver damage, including yellow-coloured skin and eyes, unusually dark-coloured urine or light-coloured stools, severe upset stomach or abdominal pain
What precautions should my doctor and I be aware of when taking this medication?
- If you are taking or planning to take any other prescription, over-the-counter medication, natural health product or supplement, check with your doctor or pharmacist to make sure there are no unsafe drug interactions.
- If you feel dizzy or drowsy during the daytime while taking this medication, do not drive a car or operate heavy machinery. Alcohol could make symptoms of dizziness or drowsiness worse. It is best to not drink any alcohol while taking pregabalin.
What should I do if I miss a dose?
If you forget to take a dose of pregabalin, take the missed dose as soon as you remember. However, if it is within 4 hours of your next scheduled dose, skip the missed dose and continue regularly with your next scheduled dose. DO NOT double your next dose to try to 'catch up'.
How do I store this medication?
Keep this medication in the original container, stored at room temperature away from moisture and heat and protect from light. Keep this medication out of reach and sight of children.
How does this medication work?
Pregabalin works by blocking calcium channels in the brain, indirectly altering the production of brain chemicals (called neurotransmitters) such as GABA, glutamate and certain peptides that reduce anxious feelings or pain signals over time.
How well does this medication work in children and adolescents?
In adults, pregabalin has shown to improve symptoms of generalized anxiety and social anxiety. In children, pregabalin has been shown to be safe, however effectiveness in improving symptoms of anxiety has not been established. Based on its effectiveness in adults and safety in children and adolescents, particularly, for those who do not respond to first line anxiety treatments, the potential benefit of using pregabalin outweighs its potential risks.
For nerve pain, pregabalin has been shown to be beneficial in people who are diagnosed with conditions including shingles, fibromyalgia and nerve pain associated with diabetes.
How long should I take this medication for?
The length of time that you take this medication will depend on the symptoms you have, how frequently they occur and how long you have had them. Most people need to take pregabalin for at least 6 months as this allows time for symptoms to stabilize. After this time, you and your doctor can discuss the benefits and risks of continuing treatment.
If you have anxiety and you tolerate pregabalin well, you may be asked to take it on an ongoing basis. If pregabalin has shown benefit for you, continuing treatment decreases the chance that your anxiety symptoms will return.
Do not increase, decrease or stop taking pregabalin without discussing it with your doctor, even if you are feeling better. If you stop taking pregabalin suddenly, your symptoms may return or you may have an unwanted reaction.
What special instructions should I follow while using this medication?
Keep all your appointments with your doctor and the laboratory. Your doctor may order lab tests to check how you are responding to the medication, and to monitor for side effects. Try to keep a healthy, well-balanced diet and exercise regularly.
Do not allow anyone else to use your medication. The medication could cause unwanted side effects in individuals who do not take pregabalin.
Attending counselling (as recommended by your doctor) increases the likelihood that this medication will help you continue to overcome anxiety.
Is this medication addictive?
Taking pregabalin may lead to physical and psychological dependence (such as being unable to sleep without medication) or abuse (taking more than prescribed). As the dosage and duration of treatment increases, the risk of dependence or abuse becomes higher.
If you have been taking pregabalin for a long period of time and suddenly stop, you may experience withdrawal symptoms such as sleep difficulties (insomnia) or return of anxiety. Talk with your doctor about how to safely lower the dose gradually to prevent withdrawal effects as your body adjusts to being without it.
