How many hours before bedtime should I take pregabalin (lyrica)?

Timing of Pregabalin Administration Before Bed

Take pregabalin at bedtime (not hours before) if using once-daily dosing, or take your evening dose at bedtime if using twice-daily or three-times-daily dosing schedules. 1, 2

Standard Dosing Schedules

Pregabalin is designed for divided dosing throughout the day, not as a single bedtime dose in most cases:

• Twice-daily dosing (BID): Take pregabalin every 12 hours, with the second dose at bedtime 1, 2
• Three-times-daily dosing (TID): Take pregabalin every 8 hours, with the final dose at bedtime 1, 2
• Starting dose: 75 mg at bedtime OR 50 mg three times daily (150 mg/day total) 1, 3

Pharmacokinetic Rationale

Pregabalin reaches peak plasma concentration within 1.5 hours after oral administration and has a half-life of approximately 6.3 hours, which explains why it requires multiple daily doses rather than a single bedtime dose 2, 4:

• Steady state is achieved within 24-48 hours of starting therapy 2, 4
• Taking with food delays peak concentration to approximately 3 hours but does not affect total absorption 2
• You can take pregabalin with or without food at bedtime 2

Practical Timing Recommendations

If your physician prescribed once-daily dosing at bedtime (typically 75 mg for initial therapy):

• Take it immediately before bed, not hours earlier 1
• This approach may help minimize daytime sedation during initial titration 1

If using standard twice-daily dosing (most common regimen):

• Take your evening dose at your regular bedtime 1, 2
• Space doses approximately 12 hours apart (e.g., 8 AM and 8 PM) 1

If using three-times-daily dosing:

• Take your final dose at bedtime 1, 2
• Critical timing consideration: If using bupropion or other activating medications, give the second pregabalin dose before 3 PM to minimize insomnia risk, though this applies to the activating medication, not pregabalin itself 5

Common Pitfalls to Avoid

• Do not take pregabalin several hours before bed expecting it to "kick in" at bedtime - the 1.5-hour peak time means taking it too early will result in peak sedation before you're ready to sleep 2
• Do not skip doses to take all medication at bedtime - pregabalin's 6.3-hour half-life requires divided dosing for consistent therapeutic effect 2, 4
• Elderly patients should use lower starting doses (consider 25-50 mg at bedtime initially) due to increased risk of dizziness, somnolence, and falls 1

Side Effect Management

Dizziness (23-46% of patients) and somnolence (15-25% of patients) are dose-dependent and most prominent during initial therapy 1:

• These effects typically develop tolerance within a few weeks 6
• Taking the evening dose at bedtime helps minimize impact on daytime function 1
• If excessive morning sedation occurs with bedtime dosing, discuss dose adjustment with your physician 1