Can Dexedrine and Lyrica Be Taken Together During the Day, Spaced One Hour Apart?
Yes, Dexedrine (dextroamphetamine) 30mg daily and Lyrica (pregabalin) can be safely taken together during the day with one-hour spacing, as there are no significant pharmacokinetic or pharmacodynamic interactions between these medications.
Evidence for Safety of This Combination
No direct drug-drug interaction exists between dextroamphetamine and pregabalin. Pregabalin is eliminated 95% unchanged by the kidneys and does not undergo hepatic metabolism via cytochrome P450 enzymes 1. Dextroamphetamine is metabolized primarily through CYP2D6, but pregabalin neither induces nor inhibits this pathway 1, 2.
The comprehensive review of antiepileptic drug interactions with various medications found no clinically significant interactions reported between pregabalin and stimulant medications 2. Pregabalin's linear pharmacokinetics and lack of enzyme induction/inhibition make it one of the safest medications to combine with other agents 1.
Practical Considerations for Concurrent Use
Timing and Administration
The one-hour spacing you propose is unnecessary from a pharmacokinetic standpoint, as these medications do not interfere with each other's absorption or metabolism 1. However, spacing may help you monitor individual medication effects and side effects more clearly.
- Pregabalin reaches peak plasma concentrations within 1-1.5 hours and has >90% oral bioavailability regardless of food intake 1
- Dextroamphetamine absorption is not affected by pregabalin 3
- You can take them simultaneously or spaced apart based purely on personal preference 1
Dosing Recommendations for Pregabalin
Start pregabalin at 75mg twice daily or 50mg three times daily (150mg/day total), increasing to a target dose of 300mg/day within one week based on tolerability 1. The 300mg/day dose provides optimal benefit-to-risk ratio for most patients 1. Reserve the maximum dose of 600mg/day only for inadequate response at 300mg/day after 2-4 weeks, as higher doses significantly increase adverse effects without consistently greater efficacy 1.
Critical Safety Warnings
Monitor closely for additive CNS depression, particularly sedation and dizziness, which are the most common side effects of pregabalin (occurring in 23-46% and 15-25% of patients respectively) 1. While dextroamphetamine's stimulant effects may partially counteract pregabalin's sedation, this is not guaranteed and individual responses vary 3.
Pregabalin carries significant abuse potential, especially in patients with substance use history 4. Case reports and epidemiological studies show pregabalin is frequently abused at doses exceeding therapeutic levels, often in combination with stimulants like methamphetamine 4, 5. One recent study found amphetamine-type stimulants were the most common substances used concomitantly with pregabalin misuse (22.8-46.9% of cases), surpassing even opioids 5.
Monitoring Requirements
Assess for signs of pregabalin misuse weekly during the first month, then monthly once stable 1. Red flags include:
- Requesting early refills or dose escalations beyond 300mg/day 4
- Using pregabalin via alternative routes (nasal insufflation, injection) 4
- Euphoric or dissociative effects at therapeutic doses 4
- Concurrent use of other substances of abuse 5
Monitor for dose-dependent side effects of pregabalin including peripheral edema (10% of patients), weight gain, dry mouth, and constipation 1. Start with lower doses and implement gradual titration to minimize these effects 1.
Common Pitfalls to Avoid
Do not assume pregabalin will enhance focus and motivation as your question suggests. Pregabalin is an anxiolytic and anticonvulsant that commonly causes sedation and cognitive slowing—effects opposite to enhanced focus 1, 4. Any perceived "focus enhancement" likely represents euphoric effects associated with abuse potential rather than therapeutic benefit 4.
Never abruptly discontinue pregabalin—taper gradually over minimum 1 week to avoid withdrawal symptoms including anxiety, insomnia, nausea, and seizures 1. Extend tapering to 2 weeks if withdrawal symptoms occur 1.
Avoid combining pregabalin with benzodiazepines or opioids, as this dramatically increases respiratory depression risk and overdose potential 1. The combination of pregabalin with CNS depressants can cause serious breathing problems 1.