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 affecting the 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, tablets, or a liquid that you swallow.
2. Key facts
- You'll usually take pregabalin 2 or 3 times a day. You can take it with or without food.
- Pregabalin is often used for epilepsy, but you can also take it to help with pain or anxiety if you do not have epilepsy.
- 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.
- If you have epilepsy it's important to take pregabalin regularly. Missing doses could trigger a seizure.
3. Who can and cannot take pregabalin
Pregabalin is only suitable for adults. It might not be suitable for people older than 65. Do not give it to children under 18.
Pregabalin is not suitable for some people. To make sure it's safe for you, tell your doctor if you:
- have ever had an allergic reaction to pregabalin or any other medicine
- have ever abused or been addicted to a medicine
- are trying to get pregnant, already pregnant or breastfeeding
- are on a controlled sodium diet, or your kidneys do not work well – some brands of pregabalin liquid contain sodium, so speak to your pharmacist or doctor before taking it
- have any problems that affect your breathing
4. How and when to take pregabalin
Pregabalin is a prescription medicine. It's important to take it as instructed by your doctor.
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 take it in the same way each day. Try to space your doses evenly through the day.
Swallow pregabalin tablets or 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. If you do not have a measuring spoon or syringe, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.
How long to take it for
If you have epilepsy, it's likely that once your condition is under control you will continue to take pregabalin for many years.
If you're taking pregabalin for nerve pain or anxiety it's likely that once your symptoms have gone you will continue to take it for several months to stop them coming back.
Changes to your dose
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.
If you forget to take it
If you forget a dose, take it as soon as you remember. If it's within 2 hours of your next dose, skip the missed dose and take your next dose at the usual time.
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.
If you take too much
Taking too much pregabalin may cause unpleasant side effects.
Immediate action required: Go to A&E now if:
You take more than your prescribed dose of pregabalin and you:
- feel sleepy
- feel confused or agitated
- have a seizure
- pass out
If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.
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 these side effects bother you or do not go away:
- feeling sleepy, tired or dizzy
- mood changes
- feeling sick
- swollen hands, arms, legs and feet
- blurred vision
- 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 or contact 111 straight away if you get:
- thoughts of harming or killing yourself – a small number of people taking pregabalin have had suicidal thoughts, sometimes after only a week of treatment
- severe dizziness or you pass out
- hallucinations (seeing or hearing things that are not 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 now 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 using the Yellow Card safety scheme.
6. How to cope with side effects of pregabalin
What to do about:
- headaches – make sure you rest and drink plenty of fluids. Try not to 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 – do not drive, cycle or use machinery until you feel better. As your body gets used to pregabalin, these side effects should wear off. If they do not wear off within a week or 2, your doctor may reduce your dose or increase it more slowly. If that does not work you may need to switch to a different medicine.
- diarrhoea – drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
- 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 avoid 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 does not help or it becomes painful, contact your doctor.
- blurred vision – do not drive, cycle or use tools or machinery 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.
- difficulties with getting an erection – speak to your doctor, as 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. Increasing your level of 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
Pregabalin and pregnancy
There is no clear evidence that pregabalin is harmful to your baby, but you'll usually only be advised to take it in pregnancy if the benefits outweigh the risks.
If you take pregabalin and become pregnant, do not stop taking the medicine without talking to your doctor first. If you take pregabalin for epilepsy, it is particularly important that this is well treated during pregnancy, as seizures can harm you and your baby.
If you're trying to get pregnant or have become pregnant while taking pregabalin, it is recommended to take high dose folic acid (5mg a day). You can get this from your doctor or midwife.
Ideally you'll take high dose folic acid for 3 months before you start trying to get pregnant and for the first 12 weeks of pregnancy. Do not worry if you have not taken it before you get pregnant, but start taking it as soon as possible once you know that you are pregnant. It helps your baby to grow normally.
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.
Pregabalin and breastfeeding
If your doctor or health visitor says your baby is healthy, you can take pregabalin while breastfeeding. It's important to keep taking pregabalin to keep you well.
Pregabalin passes into breast milk in small amounts, and it's unlikely to cause side effects in your baby.
If you're breastfeeding or planning to breastfeed, talk to your doctor or pharmacist, as other medicines we know more about might be better while you're breastfeeding, but they will help you decide.
If your baby is not feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor or midwife.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
For more information about how pregabalin can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.
8. Cautions with other medicines
Pregabalin can usually be taken safely with other medicines.
For safety, tell your doctor if you're taking any of these medicines before you start taking pregabalin:
- strong painkillers such as morphine
- medicines that make you feel sleepy or dizzy – pregabalin can make these side effects worse
Mixing pregabalin with herbal remedies and supplements
There are no known problems with taking herbal remedies and supplements with pregabalin.
However there's not enough information to say that complementary medicines and herbal remedies are always safe to take with pregabalin. They're not tested in the same way as pharmacy and prescription medicines.
Important: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
9. Common questions about pregabalin
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.
Do I need to take the same brand of pregabalin?
Most people do not 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're worried about it.
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 stop taking pregabalin?
Do not stop taking pregabalin suddenly, even if you feel fine. Stopping suddenly can cause serious problems.
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 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.
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 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 is a controlled medicine. This means there are strict rules about 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 5 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 wait longer than 28 days, 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 back to pick up your remaining medicine within 28 days of receiving your prescription. After 28 days your prescription will become invalid and your pharmacist will not be able to give you your remaining medicine without a new prescription.
Will it affect my contraception?
However, if pregabalin makes you have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.
Will it affect my fertility?
There's no evidence to suggest that taking pregabalin reduces fertility in either men or women.
But 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 it 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.
Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking pregabalin. GOV.UK has more information on the law on drugs and driving.
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.
Can I drink alcohol with it?
It's best to avoid drinking alcohol with pregabalin, because it may make you feel sleepy or make you lose your focus. It might also affect your breathing.
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.