From the Guidelines
Lyrica (pregabalin) should be used with caution due to its potential side effects, including dizziness, drowsiness, and peripheral edema, and is contraindicated in patients with known hypersensitivity to pregabalin or any components of the medication. The most common side effects of Lyrica include:
- Dizziness
- Drowsiness
- Dry mouth
- Blurred vision
- Weight gain
- Peripheral edema (swelling in extremities) Some patients may also experience cognitive impairment, mood changes, or coordination problems. More serious but less common side effects include hypersensitivity reactions, angioedema, suicidal thoughts, and respiratory depression 1. Lyrica is contraindicated in patients with known hypersensitivity to pregabalin or any components of the medication. It should be used cautiously in patients with kidney impairment, as dose adjustments are necessary based on creatinine clearance. Patients with heart failure should be monitored closely due to potential fluid retention. Lyrica carries risks during pregnancy (pregnancy category C) and should be used only if benefits outweigh risks. Abrupt discontinuation should be avoided as it may cause withdrawal symptoms including insomnia, nausea, headache, and diarrhea; tapering over at least one week is recommended. Lyrica may interact with CNS depressants, thiazolidinediones, and alcohol, potentially enhancing sedative effects or increasing risk of edema. These effects occur because pregabalin binds to voltage-gated calcium channels in the central nervous system, modulating neurotransmitter release and neural excitability. The use of Lyrica should be carefully considered, weighing the potential benefits against the potential risks, and alternative treatments should be explored if possible. According to the most recent study 1, the relative efficacy of analgesics, including Lyrica, is evaluated by comparing the number needed to treat (NNT) to achieve moderate benefit, defined as >30% pain relief.
From the FDA Drug Label
Pregabalin may cause serious side effects including: serious, even life-threatening, allergic reactions suicidal thoughts or actions serious breathing problems swelling of your hands, legs and feet dizziness and sleepiness Pregabalin is contraindicated in patients with known hypersensitivity to pregabalin or any of its components. The side effects of lyrica (pregabalin) include:
- Serious, even life-threatening, allergic reactions
- Suicidal thoughts or actions
- Serious breathing problems
- Swelling of your hands, legs and feet
- Dizziness and sleepiness The contraindications for lyrica (pregabalin) are:
- Known hypersensitivity to pregabalin or any of its components 2, 2 It is also recommended to exercise caution when taking lyrica (pregabalin) with other medicines, such as:
- Opioid pain medicine (e.g. oxycodone)
- Medicines for anxiety (e.g. lorazepam)
- Medicines for insomnia (e.g. zolpidem) 2
From the Research
Side Effects of Lyrica (Pregabalin)
- The most common side effects of Lyrica include dizziness, drowsiness, and peripheral edema 3
- Other side effects reported in studies include nausea, insomnia, hyperhidrosis, and decreased appetite 3
- Weight gain is also a possible side effect, with patients in one study gaining an average of 1.0 kg after treatment with pregabalin 3
Contraindications of Lyrica (Pregabalin)
- There is no direct evidence of contraindications for Lyrica in the provided studies
- However, studies suggest that patients with a history of substance use disorder may be at risk of abusing gabapentinoids, including Lyrica 4
- Patients who are taking other medications, such as antidepressants, may need to be monitored for potential interactions with Lyrica 5, 3
Comparison with Other Medications
- Studies have compared the efficacy and safety of Lyrica with other medications, including gabapentin and amitriptyline 6, 3
- One study found that gabapentin had fewer adverse effects than Lyrica and amitriptyline, leading to improved patient adherence for long-term use 6
- Another study found that duloxetine, pregabalin, and duloxetine plus gabapentin were generally safe and tolerable for the treatment of diabetic peripheral neuropathic pain, but with different side effect profiles 3