From the Guidelines
Pregabalin and Hypotension
Pregabalin, marketed under the brand name Lyrica, can cause hypotension in some patients, particularly at higher doses 1.
- The risk of hypotension appears to be dose-dependent, with higher doses and longer treatment durations increasing the likelihood of this adverse effect.
- In clinical trials, pregabalin doses of 300-600 mg/day have been reported to cause orthostatic hypotension in approximately 4-6% of patients, with the majority of cases being mild to moderate in severity.
- Contraindications for pregabalin include oedema, and it should be used with caution in patients with cardiovascular disease or orthostatic hypotension 1.
- Dose adjustment is required in patients with renal insufficiency, and dosage adjustments can be made in relation to creatinine clearance 1.
- It is essential to monitor blood pressure and adjust the dose accordingly to minimize the risk of hypotension.
- Alternative therapies may be considered for patients who experience hypotension or other adverse effects, such as acupuncture, near-infrared phototherapy, or low-intensity laser therapy 1.
From the Research
Adverse Effects of Lyrica (Pregabalin)
- The adverse effects profile of pregabalin is similar to that of gabapentin, and includes mainly neuropsychological reactions (dizziness and drowsiness) 2.
- Pregabalin, like gabapentin, can lead to weight gain and peripheral oedema especially in elderly patients 2.
- Somnolence and dizziness were more common with pregabalin than with placebo in patients with postherpetic neuralgia, painful diabetic neuropathy, and mixed or unclassified post-traumatic neuropathic pain 3.
- There is no mention of hypotension as a common adverse effect of pregabalin in the provided studies.
Hypotension and Pregabalin
- None of the provided studies directly address the question of whether Lyrica (pregabalin) causes hypotension.
- The studies focus on the efficacy and adverse effects of pregabalin in various conditions, including neuropathic pain, epilepsy, and restless legs syndrome 2, 3, 4, 5, 6.
- Therefore, based on the provided evidence, it is not possible to determine whether Lyrica (pregabalin) causes hypotension.