pregabalin

Adjunctive therapy • Brands: LYRICA, LYRICA CR

Last reviewed: 2025-12-29

General information

Primary label indications include: Neuropathic pain (diabetic peripheral neuropathy, postherpetic neuralgia, spinal cord injury); fibromyalgia; adjunctive therapy for partial-onset seizures (label).
Class: Adjunctive therapy
Common US brands: LYRICA, LYRICA CR
Typical dose range: For off-label anxiety/sleep use, start low and titrate slowly over days to weeks based on sedation, dizziness, and functional impact.
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2025-12-29

Dosing & forms

Forms/strengths: Capsules: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, 300 mg.; Extended-release products exist (brand-dependent); do not substitute without monitoring.
Typical range: For off-label anxiety/sleep use, start low and titrate slowly over days to weeks based on sedation, dizziness, and functional impact.

Mechanism (brief)

Alpha-2-delta (α2δ) ligand that modulates voltage-gated calcium channels and reduces excitatory neurotransmitter release.

Metabolism & Half‑life

Metabolism: Negligible metabolism; eliminated primarily unchanged (label).
Half‑life: Single-dose mean 6.3 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

View labelExact

Monitoring highlights

Check renal function (eGFR/CrCl) before starting and after clinical changes that may reduce clearance.
Monitor sedation, dizziness, and driving/fall risk during titration.
Track weight and assess peripheral edema; reassess if dyspnea or rapid weight change occurs.
Screen for misuse/diversion signals (early refills, escalating doses, co-use with opioids/alcohol).
Taper rather than stopping abruptly after sustained use.

Sources

Pregabalin prescribing information (Lyrica) — DailyMed (2025)
Gabapentin and Pregabalin for the Treatment of Anxiety Disorders — Clinical Pharmacology in Drug Development (2018)
A Meta-Analysis of the Efficacy of Pregabalin in the Treatment of Generalized Anxiety Disorder — The Canadian Journal of Psychiatry (2011)
Pregabalin for generalized anxiety disorder — International Clinical Psychopharmacology (2017)
Abuse and Misuse of Pregabalin and Gabapentin: A Systematic Review Update — Drugs (2021)

General information

Primary label indications include: Neuropathic pain (diabetic peripheral neuropathy, postherpetic neuralgia, spinal cord injury); fibromyalgia; adjunctive therapy for partial-onset seizures (label).

Class: Adjunctive therapy

Common US brands: LYRICA, LYRICA CR

Typical dose range: For off-label anxiety/sleep use, start low and titrate slowly over days to weeks based on sedation, dizziness, and functional impact.

Therapeutic drug monitoring not routinely recommended.

Last reviewed: 2025-12-29

Dosing & forms

Forms/strengths: Capsules: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, 300 mg.; Extended-release products exist (brand-dependent); do not substitute without monitoring.

Typical range: For off-label anxiety/sleep use, start low and titrate slowly over days to weeks based on sedation, dizziness, and functional impact.

Monitoring highlights

Check renal function (eGFR/CrCl) before starting and after clinical changes that may reduce clearance.

Monitor sedation, dizziness, and driving/fall risk during titration.

Track weight and assess peripheral edema; reassess if dyspnea or rapid weight change occurs.

Screen for misuse/diversion signals (early refills, escalating doses, co-use with opioids/alcohol).

Taper rather than stopping abruptly after sustained use.