From the Guidelines
The normal dose of pregabalin is 50 mg 3 times daily or 75 mg twice daily, which can be increased to 300 mg/d after 3-7 d, then by 150 mg/d every 3-7 d as tolerated, with a maximum dosage of 600 mg/d 1. When initiating pregabalin therapy, it is essential to consider the patient's renal function, as dose adjustments are necessary for those with impaired kidney function.
- The starting dose can be 50 mg 3 times daily or 75 mg twice daily.
- The dose can be increased to 300 mg/d after 3-7 days, then by 150 mg/d every 3-7 days as tolerated.
- The maximum dosage is 600 mg/d, which can be administered as 200 mg 3 times daily or 300 mg twice daily 1. It is crucial to monitor patients for adverse effects, such as dizziness, drowsiness, and weight gain, and to adjust the dose accordingly.
- Pregabalin should be taken with or without food at consistent times each day.
- When discontinuing pregabalin, the dose should be gradually tapered over at least one week to minimize withdrawal symptoms 1.
From the FDA Drug Label
2.2 Neuropathic Pain Associated with Diabetic Peripheral Neuropathy in Adults The maximum recommended dose of pregabalin is 100 mg three times a day (300 mg/day) in patients with creatinine clearance of at least 60 mL/min. 2.3 Postherpetic Neuralgia in Adults The recommended dose of pregabalin is 75 to 150 mg two times a day, or 50 to 100 mg three times a day (150 to 300 mg/day) in patients with creatinine clearance of at least 60 mL/min. 2.5 Management of Fibromyalgia in Adults The recommended dose of pregabalin for fibromyalgia is 300 to 450 mg/day.
The normal dose of pregabalin varies by indication:
- Neuropathic pain associated with diabetic peripheral neuropathy: 300 mg/day (100 mg three times a day)
- Postherpetic neuralgia: 150 to 300 mg/day (75 to 150 mg two times a day, or 50 to 100 mg three times a day)
- Fibromyalgia: 300 to 450 mg/day 2 2
From the Research
Normal Dose of Pregabalin
The normal dose of pregabalin can vary depending on the patient's response and the condition being treated.
- The initial recommended dose for neuropathic pain is 150 mg per day, which can be increased up to 300 mg per day (divided into 2-3 daily doses) during a one-week period 3.
- In patients with diabetic peripheral neuropathy and postherpetic neuralgia, doses of 50 to 200 mg three times a day have been shown to be effective in relieving pain and improving sleep and health-related quality of life 4.
- Daily doses greater than 150 mg/day may require dose titration, and the maximum dose is not specified, but doses up to 300 mg/day have been used in clinical trials 3, 4.
Factors Affecting Dose
The dose of pregabalin may need to be adjusted based on the patient's response and tolerability.
- Side effects such as dizziness, drowsiness, and peripheral edema are dose-dependent and can be managed by reducing the dose 3, 4.
- The pharmacokinetics of pregabalin are linear and dose-independent, with a narrow therapeutic dosing range 4.
- Food does not significantly affect the extent of absorption, and pregabalin is not protein-bound, with a plasma half-life of about 6 hours 5.