From the Guidelines
Lyrica (pregabalin) should be started at 50 mg 3 times daily or 75 mg twice daily and can be gradually increased based on response and tolerability to a maximum of 600 mg/day, with dose reduction necessary for patients with renal impairment, as recommended by the most recent and highest quality study 1. The dosing regimen for Lyrica (pregabalin) can vary depending on the patient's condition and response to treatment.
- The starting dose can be 50 mg 3 times daily or 75 mg twice daily,
- with a gradual increase to 300 mg/day after 3-7 days,
- and further increases of 150 mg/day every 3-7 days as tolerated,
- up to a maximum dose of 600 mg/day,
- with a reduction in dose required for patients with impaired renal function,
- and consideration of lower starting doses and slower titration in geriatric patients,
- as well as monitoring for common side effects such as dizziness, somnolence, and dry mouth,
- and potential mood changes, suicidal thoughts, and allergic reactions,
- as noted in the study published in the Mayo Clinic Proceedings 1. It's also important to note that pregabalin has linear pharmacokinetics, making dosing more straightforward compared to other medications like gabapentin,
- and that the efficacy and tolerability of pregabalin seem to be similar to those of gabapentin,
- but with the advantage of more straightforward dosing and potentially faster analgesia,
- as discussed in the study 1. Additionally, the study published in Diabetes/Metabolism Research and Reviews 1 and the Journal of the National Comprehensive Cancer Network 1 also provide guidance on the dosing and use of pregabalin,
- but the most recent and highest quality study 1 provides the most up-to-date and reliable recommendations for the use of Lyrica (pregabalin).
From the FDA Drug Label
The recommended dose of pregabalin capsules for fibromyalgia is 300 mg to 450 mg/day. The recommended dose range of pregabalin capsules for the treatment of neuropathic pain associated with spinal cord injury is 150 mg to 600 mg/day. Base the dose adjustment in patients with renal impairment on creatinine clearance (CLcr), as indicated in Table 2.
The recommended dosing regimen for Lyrica (pregabalin) varies by indication.
- For fibromyalgia, the dose is 300 mg to 450 mg/day.
- For neuropathic pain associated with spinal cord injury, the dose range is 150 mg to 600 mg/day.
- For patients with renal impairment, the dose should be adjusted based on creatinine clearance (CLcr), as indicated in Table 2 2.
From the Research
Lyrica Dosing Regimen
The recommended dosing regimen for Lyrica (pregabalin) varies depending on the condition being treated.
- For diabetic peripheral neuropathy, the dose range is 300 to 600 mg/day, divided into 2 or 3 doses 3.
- For postherpetic neuralgia, the dose range is 450 to 600 mg/day, divided into 2 or 3 doses 3.
- For refractory partial-onset seizures, the dose range is 150 to 600 mg/day, divided into 2 or 3 doses 3.
- For generalized anxiety disorder or social anxiety disorder, the dose range is 200 to 600 mg/day, divided into 2 or 3 daily doses 3.
Flexible Dosing
Some studies have used a flexible-dose regimen, where the dose is adjusted based on patient response and tolerability.
- In one study, the mean dose of pregabalin was 301 mg/day, administered in two doses, with a starting dose of 150 mg/day and dose escalation to 300 mg/day after one week 4.
- In another study, the mean dose of pregabalin was 480 mg/day, with a dose range of 150 to 600 mg/day 5.
Dose Titration
Dose titration is often used to minimize adverse effects and optimize efficacy.