From the Guidelines
The maximum daily dose of pregabalin that a person can take is 600 mg per day, typically divided into two or three equal doses, as recommended in the study published in the Mayo Clinic Proceedings 1. This dosage applies to most approved indications, including neuropathic pain, and is based on the pharmacokinetics of pregabalin, which has linear pharmacokinetics and more straightforward dosing compared to gabapentin. Some key points to consider when prescribing pregabalin include:
- Starting dosage: 50 mg 3 times daily or 75 mg twice daily, with gradual titration to the maximum dose as tolerated
- Titration: Increase by 150 mg/d every 3-7 d as tolerated, with a maximum dose of 600 mg/d
- Duration of adequate trial: 4 weeks
- Renal function: Reduce dose if impaired renal function, with specific adjustments based on creatinine clearance
- Side effects: More common at higher doses, including dizziness, drowsiness, dry mouth, edema, blurred vision, and cognitive impairment It is essential to note that patients should never adjust their dose without medical supervision, as pregabalin requires gradual titration when starting and stopping to minimize withdrawal effects, as mentioned in the study 1.
From the FDA Drug Label
2.2 Neuropathic Pain Associated with Diabetic Peripheral Neuropathy in Adults The maximum recommended dose of pregabalin is 100 mg three times a day (300 mg/day) in patients with creatinine clearance of at least 60 mL/min.
2.3 Postherpetic Neuralgia in Adults ...and who are able to tolerate pregabalin, may be treated with up to 300 mg two times a day, or 200 mg three times a day (600 mg/day)
2.4 Adjunctive Therapy for Partial-Onset Seizures in Patients 1 Month of Age and Older ...Recommended Maximum Dosage ... 600 mg/day
2.5 Management of Fibromyalgia in Adults The recommended dose of pregabalin for fibromyalgia is 300 to 450 mg/day.
The maximum daily dose of pregabalin (Lyrica) a person can take is 600 mg/day in certain conditions, such as postherpetic neuralgia and adjunctive therapy for partial-onset seizures, but the maximum recommended dose is 300 mg/day for neuropathic pain associated with diabetic peripheral neuropathy and 450 mg/day for fibromyalgia 2.
From the Research
Maximum Daily Dose of Pregabalin
The maximum daily dose of pregabalin (Lyrica) varies depending on the condition being treated.
- For the treatment of postherpetic neuralgia, painful diabetic neuropathy, central neuropathic pain, and fibromyalgia, the maximum daily dose is 600 mg/day 3, 4, 5.
- For the treatment of generalized anxiety disorder, the maximum daily dose is also 600 mg/day 6.
- For the treatment of refractory partial epilepsy, the maximum daily dose is 600 mg/day 7.
Dose-Related Adverse Effects
Adverse effects of pregabalin are dose-related, with common effects including:
Titration and Administration
Pregabalin can be administered in two or three divided doses, with titration over a period of one week to minimize adverse effects 3, 4.
- The initial recommended dose for neuropathic pain is 150 mg per day, which can be increased up to 300 mg per day depending on patient response or resistance to the drug 4.