Pregabalin: Uses, Dosage, Side Effects & Precautions

Pregabalin is a prescription medicine for nerve pain, epilepsy and anxiety, and in India it is most often dispensed in combination with methylcobalamin for diabetic nerve pain. It is also a medicine regulators watch closely.

Two facts frame the rest of this article. It can cause dependence at ordinary prescribed doses, and it is not a tablet that can simply be stopped when a person feels better.

What is pregabalin, and how does it work?

Pregabalin is the generic name of the molecule, and Lyrica is the original brand name for it. Every other name on a pharmacy shelf is a different company’s brand for the same ingredient.

MedlinePlus[1] places it in a class of medicines called anticonvulsants. It describes the way it works as decreasing the number of pain signals sent out by damaged nerves.

That explains the spread of its uses. A medicine acting on nerve signalling can be used for seizures and for pain arising from nerve damage, which are otherwise unrelated problems.

What is pregabalin used for?

The UK product information[2] lists three licensed uses in adults. They are peripheral and central neuropathic pain, add-on treatment for partial seizures, and generalised anxiety disorder.

MedlinePlus names the pain conditions more specifically. It lists diabetic nerve pain, pain after shingles, pain from spinal cord injury and fibromyalgia among the reasons it is prescribed.

India licenses combinations the UK does not. The CDSCO record of approved fixed dose combinations[3] includes pregabalin with methylcobalamin for peripheral neuropathy, cleared in 2007. A five-ingredient capsule adding alpha lipoic acid, pyridoxine and folic acid is approved for painful diabetic neuropathy in adults only.

What is the dosage for adults?

The product information gives a range rather than a single dose. It describes 150 mg to 600 mg a day, taken in either two or three divided doses.

Treatment is built up rather than started at the top. It describes beginning at 150 mg daily, with increases after a week or so depending on how a person responds and tolerates it.

The upward steps are the prescriber’s to make. Nothing in this article is a schedule to follow, because the right dose depends on the condition, on kidney function and on what else a person takes.

Why must pregabalin not be stopped suddenly?

Because stopping abruptly can cause withdrawal. The product information records insomnia, anxiety and convulsions among the effects reported when it is stopped without tapering.

The taper has a stated minimum. It advises reducing gradually over at least one week for 150 to 300 mg a day, and at least three weeks for 600 mg a day.

MedlinePlus puts the same point in plainer words. It states that pregabalin should not be stopped without talking to a doctor, even where side effects are the reason for wanting to stop.

Why is pregabalin a controlled drug? -H2

Because of dependence and diversion. In April 2019 the UK regulator[4] reclassified pregabalin and gabapentin as Class C controlled substances under the Misuse of Drugs Act. It placed them in Schedule 3 of the Misuse of Drugs Regulations at the same time.

The reason given was concern about abuse. The regulator cited misuse, illegal diversion and dependence, and advised prescribers to assess patients for a history of drug abuse before prescribing.

The product information is blunter still. It states that pregabalin can cause drug dependence, and that this may occur at therapeutic doses rather than only at high ones.

That is why dose escalation matters as a signal. The regulator asks prescribers to watch for drug-seeking behaviour, rising doses and developing tolerance during treatment.

Which brands of pregabalin are sold in India?

The molecule is the same across them, and the price is not. These are products listed on Medkart.

Brand	Marketer or manufacturer
Lyrica 75	Pfizer Pharmaceutical India Private Limited
Pregabid 75	Intas Pharmaceuticals Limited
Neugaba 75	Sun Pharmaceutical Industries Limited
Maxgalin 150	Sun Pharmaceutical Industries Limited
Pregalin 150	Torrent Pharmaceuticals Limited
Pregaba 75	Torrent Pharmaceuticals Limited

Two of those listings are marked in store only rather than orderable online, which is worth checking before travelling. More appear on the 75 mg listing and the 150 mg listing.

Is a generic pregabalin the same as a branded one?

Every product in the table contains the same active ingredient at the same strength. The name on the pack, the manufacturer and the price are what differ.

Switching between them is still a prescriber’s decision. The dose is titrated to the person, so a change of product is worth confirming rather than assuming.

Also Read: What are generic medicines?

What are the side effects of pregabalin?

The common ones affect alertness and balance. The NHS[5] names headaches, feeling sleepy, tired or dizzy, difficulty sleeping, mood changes, swollen hands and feet, blurred vision and weight gain.

One warning sits above the rest. MedlinePlus records that about one in 500 people taking it developed suicidal thoughts, sometimes within a week of starting. The NHS treats thoughts of self harm as a reason to seek emergency help.

Breathing is the other serious concern. The regulator reported in February 2021[6] that pregabalin has been associated with infrequent reports of severe respiratory depression, including in some cases without opioids involved.

Severe dizziness, fainting, or seeing or hearing things that are not there all need same-day advice on the NHS wording. A swollen mouth or throat, or struggling to breathe, needs emergency help.

Who should be careful with pregabalin?

The higher-risk groups are named rather than implied.

Situation	What the sources say
Taking opioids or other sedating medicines	The regulator links this combination with respiratory failure, coma and deaths.
High doses alongside opioids	It records that above 300 mg a day with opioids is particularly associated with opioid-related death.
Reduced kidney function	Named among the higher-risk groups, with dose adjusted to kidney function.
Breathing or neurological conditions	Both are named among the groups at higher risk of respiratory depression.
Age over 65	Named in the same list, and the product information notes falls from dizziness in older people.
A history of drug misuse	The regulator advises assessing this before prescribing, because dependence can occur at usual doses.
Driving or operating machinery	Dizziness and sleepiness are very common effects, so alertness is affected until a person knows how they react.

Anyone noticing mood changes, or thoughts of self harm, is advised to seek help rather than wait for the next appointment.

Where can you buy pregabalin on Medkart?

Pregabalin is a prescription medicine, so a valid prescription is needed. Medkart sells medicines online and highlights quality credentials for its generic range.

The brands above sit on the composition listings, where pack sizes and current prices can be seen side by side. A pharmacist can confirm whether a different listed product carries the same active ingredient at the same strength.

Nothing here says any of these treats the condition a reader has, which is a judgement for the prescriber. Medkart lists these products and does not test or approve them. Medkart’s medicine comparison tools can be used to compare listed options on:

Active ingredient
Strength
Dosage form
Manufacturer
Pack size
Current price

It is also possible to search by name, browse the full medicine list, or find the nearest Medkart store.

Key takeaways

Pregabalin is the generic name of the molecule and Lyrica is the original brand name for it.
MedlinePlus places it among the anticonvulsants and describes it as reducing pain signals from damaged nerves.
Its licensed adult uses are neuropathic pain, add-on treatment for partial seizures and generalised anxiety disorder.
The product information gives 150 mg to 600 mg a day in two or three divided doses, built up gradually.
It is tapered over at least one week, or at least three weeks from the highest dose.
The UK reclassified it as a Class C controlled drug in April 2019 over misuse and dependence.
The product information states dependence can occur at therapeutic doses, not only at high ones.
Severe respiratory depression has been reported, with the risk highest alongside opioids.

FAQs

Q. Is pregabalin a painkiller?

Not in the way paracetamol is. It is classed among the anticonvulsants and acts on nerve signalling rather than on inflammation or on pain receptors generally. That is why it is prescribed for pain arising from nerve damage rather than for a headache or a sprain.

Q. Can pregabalin be taken only when the pain is bad?

The retrieved sources do not describe it that way. It is prescribed as a regular daily dose divided across the day and built up over weeks, which is a different pattern from a tablet taken as needed. Anyone tempted to use it occasionally should raise that with the prescriber.

Q. How long does it take to work?

No single figure appears in the sources opened here, and the titration steps suggest why. The dose is raised over weeks according to response, so the answer depends on where a person settles rather than on the first tablet. The prescriber reviews progress at each step.

Q. Can it be taken with sleeping tablets or alcohol?

That combination is where the serious warnings concentrate. The regulator links pregabalin with opioids or other central nervous system depressants to respiratory failure, coma and deaths. Anything sedating, including alcohol, is worth declaring before the prescription rather than after.

Q. Does pregabalin cause weight gain?

The NHS lists weight gain among the side effects occurring in more than one in 100 people. It also lists swollen hands, arms, legs and feet separately, which can look similar. Neither is a reason to stop the medicine without advice, because stopping abruptly carries its own risk.

Q. What happens if a dose is missed?

The sources do not set out a catch-up schedule, and doubling up is not supported anywhere in them. What they are consistent about is the opposite end: stopping altogether needs a taper agreed with the prescriber. A pharmacist can advise on a single missed dose.

References

Medical disclaimer: Pregabalin is a prescription-only medicine and this article is general information rather than advice about any individual. It cannot say whether pregabalin suits a particular person, at what dose or for how long, because that depends on the condition, on kidney function and on a medical history the page cannot see. No one should start, stop, reduce or substitute this medicine without advice from the prescriber or a qualified pharmacist, and stopping suddenly carries a risk of withdrawal effects including seizures.

Pregabalin: Uses, Dosage, Side Effects, Precautions and How It Works