Lyrica is the brand name for pregabalin – an FDA-approved prescription drug that falls under the category of Schedule V drugs. The drug is mainly used to treat neuropathic pain. For those who do not know, this is the type of pain that is caused due to an abnormality of, or damage to the nerves. There are several diseases that can affect the nerves and can cause neuropathic pain. These mainly include postherpeticneuralgia (the clinical term for shingles), diabetes, and spinal cord injury. The medicine is also used to treat the pain associated with fibromyalgia.
Lyrica (pregabalin) also classifies as an anticonvulsant drug and is used as an add-on medication to treat focal onset seizures in adult epileptic patients.
An important thing to note here is that the medicine only helps to manage these conditions and is not meant to heal them.
Available Dosage Forms and Strengths of Lyrica
Lyrica is available in both capsules and oral solutions forms in the following dosage strengths:
Capsules
Lyrica capsules are available in 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, and 300 mg strengths.
Oral Solution
Lyrica oral solution is available in 20 mg/ml dosage strength.
Recommended Dosage of Lyrica
For Diabetic Peripheral Neuropathy
To get relief from the pain associated with diabetes, patients are initially prescribed to take a maximum of 150 mg per day (50 mg capsules three times a day). However, based on the patient’s tolerability and effectiveness of the drug, the dosage may be increased to 300 mg per day (100 mg capsules, three times a day), within a week.
For Shingles
The recommended initial dosage for postherpetic neuralgia is 150 mg per day (50 mg capsules three times a day or 75 mg capsules twice a day).
It can later be increased up to 300 mg per day and in some cases, up to 600 mg per day too.
For Pain Associated With Spinal Cord Injury
A 75 mg capsule taken twice a day is the recommended starting dosage of Lyrica for patients suffering from pain due to spinal cord injury.
If patients do not experience pain relief, the doctor can increase the dosage to 150 mg capsules twice a day within a week and to 300 mg capsules twice a day after another 2 to 3 weeks.
For Fibromyalgia
For patients suffering from fibromyalgia, the dosage of Lyrica can range from 150 to 450 mg per day.
For Focal Onset Seizures
Depending on a variety of factors, such as the severity of the disease and a patient’s needs and response to the drug, the maximum dosage of Lyrica can range anywhere from 150 to 600 mg per day.
Normally, the initial prescribed dosage of Lyrica is 150 mg per day (50 mg capsules three times a day or 75 mg capsules twice a day). The dosage is later gradually increased according to the patient’s tolerability and response.
Important: Since Lyrica is eliminated from the body primarily through renal excretion, its dosage needs to be adjusted in patients suffering from renal impairment.
Also, it is highly recommended not to exceed the recommended per day dosage, unless suggested by the doctor, to prevent the risks of dose-dependent side effects.
What to Do If You Miss a Dose of Lyrica
Although it suggested that you take the missed dose of Lyrica as soon as you remember, skip it if it is nearly time for the next dose and take the next dose at its time.
Never take a double dose to make up for the missed one.
Administration of Lyrica
Take the medicine as and when prescribed with or without food. However, make sure to take it at the same time every day.
Storage
While Lyrica can tolerate temperatures between 59 to 86 degrees Fahrenheit (15 to 30 degrees Centigrade), it should ideally be stored at 77 degrees Fahrenheit (25 degrees Centigrade).
Side Effects of Lyrica
Clinical studies found that the patients using Lyrica may experience one or more of the following negative effects:
Adverse Reactions of Lyrica Associated With Diabetic Pain
- Back and chest pain
- Edema, particularly in the peripheral vascular system and face
- Asthenia; chronic physical and mental fatigue
- Constipation
- Dry mouth
- Flatulence
- Weight gain
- Hypoglycemia i.e. low blood sugar
- Drowsiness
- Dizziness or vertigo
- Confusion or nervousness
- Tremor
- Euphoria
- Thinking abnormality
- Abnormal or blurry vision
- Dyspnea i.e. shortness of breath
Common Side Effects of Lyrica in Patients Suffering From Shingles
- Headache
- Flu syndrome
- Infection
- Edema
- Increased risk of accidental injury
- Dry mouth
- Vomiting
- Constipation and flatulence
- Weight gain
- Dizziness
- Drowsiness
- Confusion, abnormal thinking, and/or speech disorder
- Eye disorder and/or blurred vision
- Bronchitis
- Urinary incontinence
Patients suffering from this condition may also experience myasthenia gravis with Lyrcia usage. Myasthenia gravis is a rare autoimmune neuromuscular disease that causes weakening of the skeletal muscles.
Negative Effects of Lyrica in Patients of Fibromyalgia
- Headache
- Blurred vision
- Dizziness
- Drowsiness
- Constipation, flatulence, and/or abdominal distension
- Vomiting
- Vertigo
- Fatigue
- Edema
- Chest pain
- Feeling drunk
- Sinusitis
- Fluid retention
- Muscle spasms
- Joint pain
- Increased appetite
- Weight gain
- Back and chest pain
- Lethargy
- Tremor
- Memory impairment
- Difficulty in concentrating
- Confusion or disorientation
- Anxiety or depression
- Pharyngolaryngeal pain
Possible Adverse Reactions of Lyrica When Used for Pain Associated with Spinal Cord Injury
- Nausea, vomiting
- Constipation
- Dry mouth
- Blurred vision
- Cold
- Fatigue
- Edema
- Increased weight
- Vertigo
- Muscle weakness
- Neck and back pain
- Swelling of joints
- Drowsiness or insomnia
- Paresthesia
- Urinary incontinence
- Euphoric mood
- Hypertension or hypotension
- Decubitus ulcer
- Attention disturbance, memory impairment
- Increased levels of Creatine Kinase in the blood
Side Effects of Lyrica in Adult Epileptic Patients
- Increased appetite and weight gain
- Increased risk of accidental injury
- Amnesia; a form of memory loss
- Tremor
- Ataxia; a degenerative disease of the nervous system that causes lack of muscle coordination, which then can cause a number of problems, such as slurred speech, abnormal eye movements, and difficulty in walking and swallowing.
The risk of adverse reaction increases with rapid or abrupt discontinuation of the drug.
Precautions While Taking Lyrica
Despite the fact that Lyrica does not have a high potential for abuse and dependence, patients should be evaluated for a history of drug abuse before prescribing the medicine. In addition to this, they also need to be monitored for any signs of misuse or abuse throughout the intake period. Frequent need for dose escalation due to the development of tolerance and drug-seeking behavior are some common signs of Lyrica abuse.
As mentioned earlier, rapid or abrupt discontinuation of Lyrica can increase the risk of side effects. Hence, the dosage needs to be gradually reduced, at least over the period of one week, before it is completely stopped.
Abrupt discontinuation of the medicine can cause:
- Excessive sweating
- Trouble in sleeping
- Nausea
- Diarrhea
- Increased anxiety
- More frequent seizures (in patients of epilepsy)
Lyrica may also increase the risk of suicidal thoughts and/or behaviors in some patients. So, they need to be monitored for any unusual changes in their behavior or mood, emergence or worsening of depressive symptoms, and any other sign that reflects suicidal thinking and/or behavior.
Do not use alcohol while you are administering Lyrcia as the medicine can increase or intensify the effects of alcohol.
Some animal studies have suggested that the use of pregabalin may cause skin ulcerations. While human clinical studies have not found any increased rate of skin wounds in patients treated with Lyrica, it is highly recommended for diabetic patients to monitor their skin integrity while they are taking this drug.
While there is a lack of research on the effects of Lyrica in pregnant women, animal studies have showed increased risk and incidences of developmental toxicity, such as decreased body weight of the fetus, skeletal deformities, and retarded ossification (ossification is the process of bone formation). Animal studies, conducted on rats and rabbits, have also found the increased occurrence of fetal structural malformations.
Based on both the animal and human studies, it has been estimated that there is about 2%-4% risk of major birth defects and 15%-20% risk of miscarriage in clinically recognized pregnancies.
Healthcare experts advise against breastfeeding while taking Lyrica because small quantities of the drug have been found to be passed into milk.
The effectiveness and safety of Lyrica has not been established for pediatric use.
Patients who are being prescribed with Lyrica should avoid driving as well as getting involved in any potentially dangerous activity, such as working with machines, unless the effects of the medicine become clear. This is highly important because Lyrica can cause some patients to feel sleepy and/or dizzy and performing any of the above mentioned activities while taking the medicine can greatly increase the risk of accidental injuries.
What Should You Tell Your Doctor Before Taking Lyrica?
While it is important to tell your doctor about any and all medical conditions you are suffering from, you should specifically tell the healthcare provider about the following:
- Kidney problems and treatments that you are getting for them, specifically dialysis
- Heart problems
- Low platelet count or bleeding problem
- If you are suffering from or have had a history of severe mood swings, depression and/or suicidal thoughts or behavior.
- If you have had a history of angioedema i.e. swelling of face, throat, neck, mouth, lips, and/or gums.
- If you plan to become a parent
- If you are or plan to breastfeed
Possible Drug Interactions of Lyrica
In addition to all the health conditions, it is highly important to tell your doctor about all the medicines that you are taking whether they are prescription drugs, over-the-counter-medicines, herbal medications or supplements.
While Lyrica undergoes negligible metabolism inside the body and is mainly excreted unchanged in the urine and therefore, the possibility of drug interactions is very minimal, it is better to tell the doctor about all medicines to avoid any harmful effects.
Some of the medicines that may increase the risks of adverse effects when taken with Lyrica are:
- Actos (pioglitazone) or Avandia (rosiglitazone) – medicines taken for diabetes
- Angiotensin Converting Enzyme (ACE) Inhibitors
- Any medication that has a tranquilizing effect
- Anxiety medicines, such as Lorazepam
- Medicines that are used to treat narcotic pain, such as Oxycodone
- Ethanol
Prescription Assistance for Lyrica
Pfizer Inc. and Pfizer Patient Assistance Foundation jointly run a program called Pfizer Rx Pathways to help eligible patients learn about different assistance programs that offer insurance support, co-pay help, and free of cost medicines.
All you have to do is to visit the website of Pfizer Rx Pathways, enter the name of the desired medicine, and answer a few questions to find out the available programs. For example, a Lyrica co-pay savings card is available for patients who are uninsured or underinsured, and cannot even afford to buy the medicine. With the co-pay card, eligible patients can get Lyrica for as little as $4.
You can also check out the eligibility for Pfizer Patient Assistance Program at Rx Assist