Pregabalin

Pregabalin is used to treat epilepsy and anxiety.

It is also taken to treat nerve pain. Nerve pain can be caused by different illnesses including diabetes and shingles, or an injury.

Pregabalin works in different ways:

• in epilepsy it stops seizures by reducing the abnormal electrical activity in the brain
• with nerve pain it blocks pain by interfering with pain messages travelling through the brain and down the spine
• in anxiety it stops your brain from releasing the chemicals that make you feel anxious

Pregabalin is only available on prescription. It comes as capsules or a liquid that you drink.

• Pregabalin is usually taken 2 or 3 times a day. You can take it with or without food.
• You don't have to have epilepsy for pregabalin to help with pain or anxiety.
• It takes at least a few weeks for pregabalin to work.
• The side effects of pregabalin are usually mild and go away by themselves. The most common ones are feeling sleepy, dizziness and headaches.
• Pregabalin is also called by the brand names Lyrica, Alzain, Lecaent and Rewisca.

Pregabalin is only for adults. Do not give it to children under the age of 18.

Pregabalin is not suitable for some people:

To make sure pregabalin is safe for you, tell your doctor if you:

• have ever had an allergic reaction to pregabalin or another medicine
• have ever abused or been addicted to a medicine
• are trying to become pregnant, are already pregnant or are breastfeeding
• are on a controlled sodium or potassium diet, or your kidneys don't work well – pregabalin liquid contains sodium and potassium, speak to your doctor before taking it

Pregabalin is a prescription medicine. It's important to take it as instructed by your doctor.

Dosage

The usual dose of pregabalin is between 150mg and 600mg a day split into 2 or 3 separate doses.

If you are taking pregabalin as a liquid, 2.5ml is usually the same as taking a single 50mg capsule. Always check the label.

How to take it

You can take pregabalin with or without food, but it's best to be consistent each day. Try to space your doses evenly through the day.

Swallow pregabalin capsules whole with a drink of water or juice. Do not chew them.

If you are taking pregabalin as a liquid, it will come with a syringe or spoon to measure your dose. Do not use a kitchen spoon as it will not give the right amount. If you do not have a measuring spoon or syringe, ask your pharmacist for one.

Will my dose go up or down?

To prevent side effects, your doctor will prescribe a low dose to start with and then increase it over a few days.

Once you find a dose that suits you, it will usually then stay the same.

How long will I take it for?

If you have epilepsy, it is likely that once your illness is under control you will continue to take pregabalin for many years.

If you are taking pregabalin for nerve pain or anxiety it is likely that once your symptoms have gone you will continue to take it for several months to stop them coming back.

What if I forget to take it?

If you forget a dose, take it as soon as you remember. If it is within 2 hours of the next dose, it is better to leave out the missed dose and take your next dose as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you have epilepsy, it's important to take this medicine regularly. Missing doses may trigger a seizure.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Taking too much pregabalin may cause unpleasant side effects.

Call your doctor or go to A&E now if:

Like all medicines, pregabalin can cause side effects although not everyone gets them.

Common side effects

These common side effects may happen in more than 1 in 100 people. They are usually mild and go away by themselves. Keep taking the medicine but tell your doctor if they bother you or don't go away:

• headaches
• feeling sleepy, tired or dizzy
• diarrhoea
• mood changes
• feeling sick
• swollen hands, arms, legs and feet
• blurred vision
• for men, difficulties with getting an erection
• weight gain – because pregabalin can make you feel hungry
• memory problems

If you have diabetes, pregabalin can upset your blood sugar control. Monitor your blood sugar more often for the first few weeks of treatment with pregabalin and adjust your diabetes treatment if you need to. Talk to your doctor or diabetes nurse if you want more advice on what to do.

Serious side effects

Very few people taking pregabalin have serious problems. Call a doctor straight away if you get:

• thoughts of harming or killing yourself – a small number of people taking pregabalin have had suicidal thoughts that can happen after only a week of treatment
• difficulties breathing
• severe dizziness or you pass out
• hallucinations (seeing or hearing things that aren't real)
• problems going to the toilet, including blood in your pee, needing to pee more often, or constipation

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to pregabalin.

These are not all the side effects of pregabalin. For a full list see the leaflet inside your medicines packet.

What to do about:

• headaches – make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking pregabalin. Talk to your doctor if they last longer than a week or are severe.
• feeling sleepy, tired or dizzy – as your body gets used to pregabalin, these side effects should wear off. If they do not wear off within a week or 2, your doctor may reduce your dose or increase it more slowly. If that doesn't work you may need to switch to a different medicine.
• mood changes – if you feel this medicine is causing mood changes , speak to your doctor as you may need a change of medicine.
• feeling sick – take pregabalin with or after a meal or snack to ease your symptoms. It may also help if you don't eat rich or spicy food.
• swollen hands, arms, legs and feet – if your feet are swollen, try sitting with your feet up on a chair or bed and try not to stand for a long time. Exercise might help if your arms are swollen. If that does not help or it becomes painful, contact your doctor.
• blurred vision – avoid driving or using tools or machines while this is happening. If it lasts for more than a day or 2 speak to your doctor as they may need to change your treatment.
• for men, difficulties with getting an erection – speak to your doctor, they may be able to change your medicine or offer other treatments that might help with this problem.
• weight gain – pregabalin can make you hungrier so it can be quite a challenge to stop yourself putting on weight. Try to eat well without increasing your portion sizes. Do not snack on foods that contain a lot of calories, such as crisps, cakes, biscuits and sweets. If you're hungry between meals, eat fruit and vegetables and low-calorie foods. Regular exercise will also help to keep your weight stable.
• memory problems – if you're having problems with your memory, speak to your doctor. They may want to try a different medicine.

There is no clear evidence that pregabalin is harmful to an unborn baby but for safety you're usually only advised to take it in pregnancy if the benefits outweigh the risks.

If you take pregabalin for epilepsy and become pregnant, do not stop the medicine without talking to your doctor first. It's very important that epilepsy is treated during pregnancy as seizures can harm you and your unborn baby.

If you're trying to get pregnant or have become pregnant, you're routinely recommended to take at least 400mcg of a vitamin called folic acid every day. It helps the unborn baby grow normally.

Pregnant women who take pregabalin are recommended to take a higher dose of folic acid. Your doctor might prescribe a high dose of folic acid (5mg a day) for you to take during the first 12 weeks of pregnancy.

If you take pregabalin around the time of giving birth, your baby may need extra monitoring for a few days after they're born. This is because they may have pregabalin withdrawal symptoms.

For more information about how pregabalin can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.

Pregabalin and breastfeeding

Tiny amounts of pregabalin can get into breast milk, but it's not clear whether it can harm the baby.

Talk to your doctor, as other drugs might be better while you're breastfeeding.

Pregabalin can usually be safely mixed with other medicines.

For safety, tell your doctor if you're taking these medicines before you start pregabalin:

• strong painkillers such as morphine
• medicines which make you feel sleepy or dizzy (pregabalin can worsen these side effects)

Mixing pregabalin with herbal remedies and supplements

There are no known problems with taking herbal remedies and supplements with pregabalin.