Iron Supplements and Lyrica (Pregabalin): No Clinically Significant Interaction
Iron supplements do not interfere with the efficacy of Lyrica (pregabalin), and the two medications can be taken together without separation or timing concerns. There is no documented pharmacokinetic or pharmacodynamic interaction between iron and pregabalin in the medical literature or clinical guidelines.
Why This Combination Is Safe
Different absorption mechanisms: Pregabalin is absorbed via the large neutral amino acid transporter system in the intestine, while iron is absorbed through specific iron transporters (DMT1) in the duodenum and proximal jejunum 1, 2.
No chelation risk: Iron forms complexes (chelates) with certain medications including tetracyclines, penicillamine, methyldopa, levodopa, carbidopa, ciprofloxacin, thyroxine, and captopril, but pregabalin does not have the chemical structure that would allow iron binding 2.
No shared metabolic pathways: Pregabalin is not metabolized by the liver and is excreted unchanged in urine, so it does not compete with iron for metabolic processing 3.
Practical Dosing Recommendations
For optimal iron absorption (not related to Lyrica interaction):
Take iron supplements in the morning on an empty stomach with approximately 100 mg of vitamin C or a glass of citrus juice 1.
Avoid taking iron with tea, coffee, milk, or calcium-containing foods, as these significantly reduce iron absorption by up to 54% 4, 1.
Consider once-daily or alternate-day dosing of iron to minimize gastrointestinal side effects and potentially improve fractional absorption 5, 1.
Do not lie down for 30-60 minutes after taking iron to reduce the risk of pill esophagitis 1.
For Lyrica dosing:
Pregabalin can be taken with or without food and at any time of day as prescribed 3.
There is no need to separate Lyrica from iron supplements by any specific time interval.
Important Context for Specific Populations
If you have restless legs syndrome (RLS):
The American Academy of Sleep Medicine recommends pregabalin as a strong first-line treatment for RLS 3.
Iron supplementation is also recommended for RLS patients with serum ferritin ≤75 ng/mL or transferrin saturation <20% 3.
Both treatments can and should be used together when indicated, as they work through different mechanisms—pregabalin modulates calcium channels while iron corrects the underlying iron deficiency that contributes to RLS pathophysiology 3.
Common Pitfalls to Avoid
Do not assume all medications interact with iron: While iron does interact with several medications, pregabalin is not among them 2.
Do not separate doses unnecessarily: Unlike calcium supplements (which should be separated from iron by 1-2 hours), there is no need to time pregabalin away from iron 3, 4.
Monitor for iron-related side effects independently: Constipation occurs in approximately 12% of patients taking oral iron; consider starting MiraLAX 17 grams daily prophylactically if this is a concern 6, 5.