Does Pregabalin Cause Bruising?
Pregabalin does not cause bruising as a recognized adverse effect. The FDA-approved drug label and clinical guidelines do not list bruising or ecchymosis among pregabalin's documented side effects 1.
Documented Adverse Effects of Pregabalin
The most common and well-established side effects of pregabalin include:
Neurological Effects
- Dizziness (23-46% of patients) and somnolence (15-25%) are the most frequent adverse effects 2, 3
- Blurred vision occurs in approximately 7% of patients treated with pregabalin versus 2% with placebo 1
- Cognitive effects including confusion are common, particularly at higher doses 2
Peripheral Effects
- Peripheral edema occurs in approximately 10% of patients and is dose-dependent 3, 1
- Weight gain is a recognized side effect 2
Hematologic Considerations
The FDA label specifically addresses platelet effects, which is the closest hematologic finding to bruising:
- Pregabalin causes a decrease in platelet count (mean maximal decrease of 20 × 10³/µL compared to 11 × 10³/µL with placebo) 1
- However, pregabalin was NOT associated with an increase in bleeding-related adverse reactions in randomized controlled trials 1
- Only 3% of pregabalin patients experienced a potentially clinically significant decrease in platelets (defined as 20% below baseline and <150 × 10³/µL) 1
Clinical Implications
If a patient on pregabalin develops bruising, alternative causes should be investigated rather than attributing it to the medication:
- Evaluate for concurrent anticoagulant or antiplatelet use 2
- Assess for NSAIDs, SSRIs, or SNRIs that increase bleeding risk 2
- Consider other medications or medical conditions causing thrombocytopenia
- Check complete blood count if bruising is unexplained
Common Pitfalls to Avoid
- Do not discontinue pregabalin solely for bruising without investigating other causes
- Be aware that the documented platelet decrease with pregabalin does not translate to clinical bleeding complications 1
- Remember that peripheral edema (a common pregabalin side effect) should not be confused with bruising 3, 1