Common Side Effects of Lyrica (Pregabalin)
Lyrica (pregabalin) commonly causes dizziness, somnolence, dry mouth, peripheral edema, blurred vision, weight gain, and difficulty with concentration/attention as its most frequent side effects. 1
Most Common Side Effects
According to the FDA drug label, the most common adverse reactions in adults taking pregabalin include:
Neurological effects:
- Dizziness (21% of patients)
- Somnolence/sleepiness (12%)
- Ataxia (3%)
- Confusion (2%)
- Thinking abnormal (2%)
- Incoordination (2%)
Physical effects:
- Peripheral edema (9%)
- Dry mouth (reported frequently)
- Weight gain (4%)
- Blurred vision (4%)
These side effects occur significantly more frequently with pregabalin than with placebo, with dizziness and somnolence being the most common reasons for discontinuation of the medication 1.
Dose-Related Side Effects
The risk and severity of side effects are dose-dependent:
- Higher doses (300-600 mg/day) are associated with greater incidence of adverse effects
- At 600 mg/day, approximately 12% of patients experience peripheral edema compared to only 2% in the placebo group 2
- Weight gain is more common at higher doses (6% at 600 mg/day versus 0% with placebo) 1
Serious Side Effects to Monitor
While less common, pregabalin may cause serious adverse effects including:
- Angioedema (swelling of face, mouth, lips, gums, throat)
- Hypersensitivity reactions
- Suicidal thoughts or behavior
- Respiratory depression (especially when combined with CNS depressants)
- PR interval prolongation (cardiac conduction changes)
- Decreased platelet count
- Creatine kinase elevations
- Ophthalmological effects (visual field changes) 1
Special Populations
- Elderly patients: More susceptible to dizziness, somnolence, peripheral edema, and weight gain
- Patients with renal impairment: Require dose adjustment as pregabalin is primarily eliminated unchanged in urine
- Patients taking other CNS depressants: Higher risk of dizziness, somnolence, and respiratory depression 1
Discontinuation Effects
Abrupt or rapid discontinuation of pregabalin may cause:
- Headaches
- Nausea
- Diarrhea
- Insomnia
- Increased sweating
- Anxiety
- Seizures (in patients with epilepsy) 1
Pregabalin should be tapered gradually over at least one week rather than stopped suddenly to minimize withdrawal effects 1.
Cardiovascular Considerations
There have been reports of heart failure associated with pregabalin use, particularly in elderly patients with pre-existing cardiovascular conditions 3. The peripheral edema caused by pregabalin may contribute to cardiac complications in susceptible individuals.
Drug Interactions
Pregabalin may have additive effects when combined with:
- Opioid pain medications
- Benzodiazepines and other sedatives
- Alcohol (should be avoided while taking pregabalin)
- ACE inhibitors (may increase risk of angioedema) 1
Understanding these side effects is essential for patients to recognize potential issues and report them promptly to their healthcare provider for appropriate management.