Pregabalin Does Not Cause Sinusitis
Pregabalin (Lyrica) is not associated with causing sinusitis. There is no evidence in the medical literature linking pregabalin use to the development of sinus infections or inflammation.
Understanding the Evidence
The provided guidelines and research comprehensively address sinusitis causes, risk factors, and associated conditions, with no mention of pregabalin as a causative or contributing factor 1, 2.
Known Causes of Sinusitis
The established predisposing factors for sinusitis include 1:
- Viral upper respiratory tract infections (most common precipitant)
- Respiratory allergies
- Conditions affecting sinus ostia patency (anatomic obstruction)
- Mucociliary dysfunction (e.g., cystic fibrosis)
- Immunodeficiency states
- Dental infections (particularly for maxillary sinusitis)
- Prolonged nasotracheal intubation (nosocomial sinusitis)
Drug-Induced Rhinitis vs. Sinusitis
While certain medications can cause rhinitis (nasal symptoms), these are distinct from sinusitis 1:
- ACE inhibitors
- Phosphodiesterase-5 inhibitors
- Alpha-receptor antagonists
- Topical decongestants (causing rhinitis medicamentosa)
- NSAIDs and aspirin
Pregabalin is not listed among medications that cause drug-induced rhinitis or sinusitis 1.
Pregabalin's Actual Side Effect Profile
The well-established adverse effects of pregabalin include 3, 4:
- Central nervous system effects: sedation, dizziness
- Peripheral edema
- Dry mouth
- Weight gain
Sinusitis, nasal congestion, or upper respiratory symptoms are not recognized adverse effects of pregabalin 5, 3, 4.
Clinical Implications
If a patient on pregabalin develops sinusitis, the clinician should 1, 2:
- Evaluate for typical sinusitis risk factors (recent viral URI, allergies, anatomic abnormalities)
- Assess symptom duration (>10-14 days suggests bacterial sinusitis)
- Look for cardinal symptoms: purulent nasal discharge, facial pain, nasal congestion
- Consider CT imaging if diagnosis is uncertain or symptoms persist despite therapy
- Treat the sinusitis according to standard guidelines without discontinuing pregabalin
The development of sinusitis in a patient taking pregabalin represents coincidental occurrence rather than drug causation.