1. About pregabalin
Pregabalin works in different ways:
- in epilepsy it stops seizures by reducing the abnormal electrical activity in the brain
- with nerve pain it blocks pain by interfering with pain messages travelling through the brain and down the spine
- in anxiety it stops your brain from releasing the chemicals that make you feel anxious
Pregabalin is only available on prescription. It comes as capsules or a liquid that you drink.
2. Key facts
- Pregabalin is usually taken 2 or 3 times a day. You can take it with or without food.
- You don't have to have epilepsy for pregabalin to help with pain or anxiety.
- It takes at least a few weeks for pregabalin to work.
- The side effects of pregabalin are usually mild and go away by themselves. The most common ones are feeling sleepy, dizziness and headaches.
- Pregabalin is also called by the brand names Lyrica, Alzain, Lecaent and Rewisca.
3. Who can and can't take pregabalin
Pregabalin is only for adults. Do not give it to children under the age of 18.
Pregabalin isn't suitable for some people:
To make sure pregabalin is safe for you, tell your doctor if you:
- have ever had an allergic reaction to pregabalin or another medicine in the past
- have ever abused or been addicted to a medicine
- are trying to become pregnant, are already pregnant or are breastfeeding
- are on a controlled sodium or potassium diet, or your kidneys don't work well - pregabalin liquid contains sodium and potassium, speak to your doctor before taking it
4. How and when to take it
Pregabalin is a prescription medicine. It's important to take it as instructed by your doctor.
How much will I take?
The usual dose of pregabalin is between 150mg and 600mg a day split into 2 or 3 separate doses.
If you are taking pregabalin as a liquid, 2.5ml is usually the same as taking a single 50mg capsule. Always check the label.
How to take it
You can take pregabalin with or without food, but it's best to be consistent each day. Try to space your doses evenly through the day.
Swallow pregabalin capsules whole with a drink of water or juice. Do not chew them.
If you are taking pregabalin as a liquid, it will come with a syringe or spoon to measure your dose. Do not use a kitchen spoon as it will not give the right amount. If you don't have a measuring spoon or syringe, ask your pharmacist for one.
Will my dose go up or down?
To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few days.
Once you find a dose that suits you, it will usually then stay the same.
How long will I take it for?
If you have epilepsy, it is likely that once your illness is under control you will continue to take pregabalin for many years.
If you are taking pregabalin for nerve pain or anxiety it is likely that once your symptoms have gone you will continue to take it for several months to stop them coming back.
What if I forget to take it?
If you forget a dose, take it as soon as you remember. If it is within 2 hours of the next dose, it is better to leave out the missed dose and take your next dose as normal.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you have epilepsy, it's important to take this medicine regularly. Missing doses may trigger a seizure.
If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
What if I take too much?
Taking too much pregabalin by accident may cause unpleasant side effects.
Urgent advice: Call your doctor or go to A&E straight away if you take too much pregabalin by accident and:
- feel sleepy
- feel confused or agitated
- have a seizure
- pass out
Find your nearest hospital accident and emergency (A&E) department straight away.
Do not drive yourself - get someone else to drive you or call for an ambulance.
If you need to go to hospital, take the pregabalin packet or leaflet inside it plus any remaining medicine with you.
5. Side effects
Like all medicines, pregabalin can cause side effects although not everyone gets them.
Common side effects
These common side effects may happen in more than 1 in 100 people. They are usually mild and go away by themselves. Keep taking the medicine but tell your doctor if they bother you or don't go away:
- feeling sleepy, tired or dizzy
- mood changes
- feeling sick
- swollen hands, arms, legs and feet
- blurred vision
- for men, difficulties with getting an erection
- weight gain - because pregabalin can make you feel hungry
- memory problems
If you have diabetes, pregabalin can upset your blood sugar control. Monitor your blood sugar more often for the first few weeks of treatment with pregabalin and adjust your diabetes treatment if you need to. Talk to your doctor or diabetes nurse if you want more advice on what to do.
Serious side effects
Very few people taking pregabalin have serious problems. Call a doctor straight away if you get:
- thoughts of harming or killing yourself - a small number of people taking pregabalin have had suicidal thoughts that can happen after only a week of treatment
- difficulties breathing
- severe dizziness or you pass out
- hallucinations (seeing or hearing things that aren't real)
- problems going to the toilet, including blood in your pee, needing to pee more often, or constipation
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to pregabalin.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of pregabalin. For a full list see the leaflet inside your medicines packet.
You can report any suspected side effect to the UK safety scheme.
6. How to cope with side effects
What to do about:
- headaches - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking pregabalin. Talk to your doctor if they last longer than a week or are severe.
- feeling sleepy, tired or dizzy - as your body gets used to pregabalin, these side effects should wear off. If they don't wear off within a week or 2, your doctor may reduce your dose or increase it more slowly. If that doesn't work you may need to switch to a different medicine.
- mood changes - if you feel this medicine is causing mood changes , speak to your doctor as you may need a change of medicine.
- feeling sick - take pregabalin with or after a meal or snack to ease your symptoms. It may also help if you don't eat rich or spicy food.
- swollen hands, arms, legs and feet - if your feet are swollen, try sitting with your feet up on a chair or bed and try not to stand for a long time. Exercise might help if your arms are swollen. If that doesn't help or it becomes painful, contact your doctor.
- blurred vision - avoid driving or using tools or machines while this is happening. If it lasts for more than a day or 2 speak to your doctor as they may need to change your treatment.
- for men, difficulties with getting an erection - speak to your doctor, they may be able to change your medicine or offer other treatments that might help with this problem.
- weight gain - pregabalin can make you hungrier so it can be quite a challenge to stop yourself putting on weight. Try to eat well without increasing your portion sizes. Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets. If you're hungry between meals, eat fruit and vegetables and low-calorie foods. Regular exercise will also help to keep your weight stable.
- memory problems - if you're having problems with your memory, speak to your doctor. They may want to try a different medicine.
7. Pregnancy and breastfeeding
There is no firm evidence that pregabalin is harmful to an unborn baby but for safety you're usually only advised to take it in pregnancy if the benefits outweigh the risks.
If you take pregabalin for epilepsy and become pregnant, do not stop the medicine without talking to your doctor first. It's very important that epilepsy is treated during pregnancy as seizures can harm you and your unborn baby.
If you're trying to get pregnant or have become pregnant, you're routinely recommended to take at least 400mcg of a vitamin called folic acid every day. It helps the unborn baby grow normally.
Pregnant women who take pregabalin are recommended to take a higher dose of folic acid. Your doctor might prescribe a high dose of folic acid (5mg a day) for you to take during the first 12 weeks of pregnancy.
If you take pregabalin around the time of giving birth, your baby may need extra monitoring for a few days after they're born. This is because they may have pregabalin withdrawal symptoms.
For more information about how pregabalin can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.
Pregabalin and breastfeeding
Tiny amounts of pregabalin can get into breast milk, but it's not clear whether it can harm the baby.
Talk to your doctor, as other drugs might be better while you're breastfeeding.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
8. Cautions with other medicines
Pregabalin can usually be safely mixed with other medicines.
For safety, tell your doctor if you're taking these medicines before you start pregabalin:
- strong painkillers such as morphine
- medicines which make you feel sleepy or dizzy (pregabalin can worsen these side effects)
Mixing pregabalin with herbal remedies and supplements
There are no known problems with taking herbal remedies and supplements with pregabalin.
For safety, tell your doctor or pharmacist if you're taking any other medicine, including herbal remedies, vitamins or supplements.
9. Common questions
How does pregabalin work?
It's not clear exactly how pregabalin works.
In epilepsy, it's thought that it stops seizures by reducing the abnormal electrical activity in the brain.
With nerve pain, it's thought to block pain by interfering with pain messages travelling through the brain and down the spine.
In anxiety, it's thought that it stops your brain from releasing the chemicals that make you feel anxious.
Is it safe to take it for a long time?
There's no evidence that pregabalin has lasting harmful effects, even if you take it for many months or years.
Should I stick to the same brand of pregabalin?
Most people don't have to stay on the same brand of pregabalin as there is very little difference between brands. Talk to your doctor if you have been asked to switch to a different brand and you are worried about that.
If your epilepsy has been hard to control in the past and the brand you are now taking is working well for you, your doctor may recommend you stay on the same one.
Can I get addicted to pregabalin?
Some people have become addicted to pregabalin after taking it for a long time. If this happens, you will have withdrawal symptoms after you stop taking the medicine. Talk to your doctor if you're concerned you are becoming physically dependant on pregabalin.
What happens when I come off pregabalin?
Do not stop taking pregabalin suddenly even if you feel fine.
If you have epilepsy, stopping pregabalin suddenly can cause seizures that will not stop.
If you are taking it for any reason and stop suddenly, you may have a severe withdrawal syndrome. This can have unpleasant symptoms, including:
- difficulty sleeping
- feeling sick
It's possible to prevent withdrawal seizures and other symptoms by gradually reducing the dose of pregabalin.
Do not stop taking pregabalin without talking to your doctor. Stopping pregabalin suddenly can cause serious problems.
Can I get epilepsy medicines for free?
If you have epilepsy, you're entitled to free prescriptions for all of your medicines (not just your epilepsy ones).
To claim your free prescriptions you'll need to have a medical exemption certificate. The application form for the medical exemption certificate is called FP92A. You can get this from your doctor's surgery.
You will need to fill in the form, then your doctor will sign it and send it off.
Are there similar medicines to pregabalin?
Gabapentin (also called Neurontin) is a medicine that works in a similar way to pregabalin. Like pregabalin, it can also be taken to treat epilepsy and nerve pain. It can also be taken for migraines. However, there are other differences between pregabalin and gabapentin. Gabapentin is taken in different doses to pregabalin.
If you need to change to gabapentin treatment, your doctor will explain how to safely swap from pregabalin.
Is pregabalin a controlled medicine?
Pregabalin has been a controlled medicine since 1 April 2019. This means there are strict rules on how it's prescribed and dispensed to make sure it's not given to the wrong person or misused.
When you collect pregabalin your pharmacist will ask for proof of identity such as your passport or driving licence. You'll also be asked to sign the back of your prescription, to confirm that you've received it.
If you're collecting pregabalin for someone else, you're legally required to show the pharmacist proof of your identity if asked.
How do I pick up a prescription for a controlled medicine?
Your pregabalin prescription will probably need to be hand signed by a doctor. This can take longer than normal repeat prescriptions.
It’s best to hand in your repeat prescription request up to five days before you’re due to run out of pregabalin. This will give your doctor enough time to sign it.
Once your prescription has been written, you’ll need to collect your medicine from a pharmacist within 28 days. If you don’t, your prescription will become invalid and you’ll need to get a new one.
If your pharmacist is unable to give you the whole amount prescribed, you’ll need to go again to pick up your remaining medicine.
You’ll need to do this within the 28 days of receiving your prescription otherwise it’ll become invalid. Your pharmacist won’t be able to give you your remaining medicine and you’ll need to get a new prescription again.
Will it affect my contraception?
Pregabalin doesn't stop any contraception working. You can safely use any type of contraception, including contraceptive pills and emergency contraception, alongside pregabalin.
Will it affect my fertility?
There's no firm evidence to suggest that taking pregabalin will reduce fertility in either men or women.
However, for safety speak to a pharmacist or your doctor before taking it if you're trying to get pregnant.
Can I drive or ride a bike?
Do not drive a car or ride a bike if pregabalin makes you sleepy, gives you blurred vision or makes you feel dizzy, clumsy or unable to concentrate or make decisions. This may be more likely when you first start taking pregabalin but could happen at any time - for example when starting another medicine.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
GOV.UK has more information on the law on drugs and driving. Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking pregabalin.
If you have epilepsy, you're not allowed to drive until you have had no seizures for 1 year.
If you change your epilepsy medicine, your doctor will tell you whether you need to stop driving and for how long.
Driving rules if you change or withdraw your medicine, Epilepsy Action
Epilepsy and driving information, GOV.UK
Can I drink alcohol with it?
You can drink alcohol with pregabalin but it may make you feel sleepy or make you lose your focus.
During the first few days of taking pregabalin, it might be best to stop drinking alcohol until you see how the medicine affects you.
Will recreational drugs affect it?
Pregabalin can intensify the highs of recreational drugs like cannabis and heroin. So, if you use recreational drugs alongside pregabalin, there may be more chance of unpleasant side effects like panic attacks, anxiety and memory loss.