From the Guidelines
Yes, Lyrica (pregabalin) can cause constipation as a side effect, with a prevalence of approximately 4-6% of patients taking the medication. This is because Lyrica works by binding to calcium channels in the nervous system, which can affect the nerves that control intestinal movement, leading to slower intestinal motility and harder, less frequent bowel movements 1.
Managing Constipation
To manage constipation while taking Lyrica, several strategies can be employed:
- Staying well-hydrated
- Increasing dietary fiber intake
- Maintaining physical activity
- Establishing regular bathroom routines For persistent constipation, over-the-counter stool softeners or mild laxatives might be appropriate, but it is crucial to consult a healthcare provider before adding any medications 1.
Treatment Options
According to recent guidelines, a stimulant laxative or polyethylene glycol with adequate fluid intake can be recommended for prophylaxis against constipation in patients taking medications that may cause constipation, such as opioids 1. However, the effectiveness of these treatments may vary, and individual patient needs should be considered.
Important Considerations
It is essential not to stop taking Lyrica abruptly due to constipation or other side effects without medical guidance, as sudden discontinuation can cause withdrawal symptoms. Instead, patients should work closely with their healthcare provider to manage side effects and adjust their treatment plan as necessary.
From the FDA Drug Label
Gastrointestinal disorders Constipation 1 1 7 4 2
Gastrointestinal disorders Constipation 8.2 5.7
There are postmarketing reports of events related to reduced lower gastrointestinal tract function (e.g., intestinal obstruction, paralytic ileus, constipation) when pregabalin was co-administered with medications that have the potential to produce constipation, such as opioid analgesics.
Constipation is a reported adverse reaction of Lyrica (pregabalin) in clinical trials and postmarketing experience, with an incidence of 1-8.2% in different studies 2, 2, and 2. The risk of constipation may be increased when pregabalin is co-administered with other medications that can cause constipation.
From the Research
Constipation as a Side Effect of Lyrica
- Lyrica, also known as pregabalin, has been reported to cause constipation in some patients, with a study finding that 7.5% of patients developed significant constipation within 1-2 weeks of commencing pregabalin 3.
- The severity of constipation symptoms was found to be dose-dependent, and constipation was the most frequent adverse effect that required pregabalin to be withdrawn 3.
- Another study found that pregabalin did not have a significant effect on constipation-BSS scores, suggesting that it may not exacerbate constipation in patients with irritable bowel syndrome 4.
Management of Constipation
- The use of laxatives is not always warranted for constipation, and increases in physical activity, fluid intake, and dietary fiber may be sufficient to control constipation 5.
- A comprehensive literature review found that fiber must resist fermentation and significantly increase stool water content and stool output to exert a laxative effect 6.
- The review also found that poorly fermented insoluble fiber, such as wheat bran, can mechanically irritate the gut mucosa and stimulate water and mucous secretion, while readily fermented soluble fiber has no effect on stool output or stool water content 6.