From the Research
Lyrica (pregabalin) is not contraindicated in patients with chronic liver disease, but dose adjustment is necessary, as evidenced by the most recent and highest quality study 1.
Key Considerations
- Pregabalin is primarily eliminated unchanged through the kidneys, so renal function should be assessed in patients with liver disease as well 2.
- Although pregabalin is not significantly metabolized by the liver (less than 2% of the drug undergoes hepatic metabolism), patients with liver disease may have altered drug clearance due to changes in plasma proteins, fluid distribution, and potential concurrent kidney dysfunction 2.
- Monitor patients with liver disease more closely for side effects such as dizziness, somnolence, peripheral edema, and weight gain when using pregabalin 3.
- If side effects occur, further dose reduction may be necessary, and regular liver function monitoring is advisable during treatment, though pregabalin itself has not been associated with hepatotoxicity in most patients 1.
Dosing Recommendations
- Patients with hepatic impairment should typically receive 50% of the normal pregabalin dose, as the drug's pharmacokinetics are not significantly affected by liver disease, but caution is still necessary due to potential changes in drug clearance and increased sensitivity to side effects 2, 1.
- Renal function should be closely monitored, and dose adjustments made accordingly, as pregabalin is primarily eliminated through the kidneys 2.