Lyrica (Pregabalin)

Brand name: Lyrica (generic: pregabalin)

Overall comments
Lyrica (pronounced LEER-i-kah) is an anti-convulsant (seizure) medicine and considered by many to be a pain relief medication. It is indicated for treatment of four specific conditions, and though it is not indicated or FDA approved for use to treat pain, it is prescribed (off label) by doctors to treat certain types of chronic pain.

Drug class and mechanism of action
Lyrica is an oral medication that is classified as an anti-seizure drug (also called anti-convulsant). Lyrica binds to a part of the nerves and it is thought that this reduces the ability for nerves to send pain messages to each other; it slows down impulses in the brain that cause seizures, and affects chemicals in the brain that send pain signals across the nervous system.

Indications for use
Lyrica is an FDA-approved medication for use in adults 18 years and older to treat:

• Fibromyalgia
• Diabetic peripheral neuropathy

• Seizures
• Herpes zoster pain (postherpetic neuralgia)

While Lyrica is not indicated to treat pain from conditions other than those listed above, physicians do sometimes prescribe it to treat certain forms of pain, such as back pain and chronic pain. This is known as off label prescribing.

Lyrica is believed to have low potential for abuse or addiction (a Schedule V medication). For some patients, Lyrica starts to work in as little as one week. For others, it may take several weeks before taking effect, so patients should be sure to discuss this with their doctor.

Potential risks and side effects
As with any medication, there are several reported potential risks and side effects with taking Lyrica. These include but are not limited to:

More common:

• Dizziness
• Sleepiness, drowsiness
• Weight gain and swelling of the hands

Less common:

• Blurred vision
• Fluid retention
• Loss of balance, lack of coordination
• Dry mouth
• Difficulty concentrating

Rare:

• Rash, allergic reactions
• Constipation, stomach pain
• Joint pain, muscle cramping

Lyrica may cause varying levels of sleepiness and drowsiness in certain people. For some, this may mean that they have to avoid any activity that requires them to stay alert, such as driving. Alcohol and other medicines that cause sleepiness (such as cold medicine, muscle relaxants, certain pain, seizure, depression or anxiety medications) can significantly compound Lyrica’s sedative effects.

Some patients taking Lyrica have reported allergic reactions (such as swelling of the face, lips, neck, or hives, difficulty breathing). Patients with any allergic reactions should stop taking Lyrica and contact their doctor promptly.

There are no conclusive studies about the effects of pregabalin in pregnant women, nor is known if the drug passes through the nursing mother’s breast milk or what the effect on a baby would be if a man taking this medication and fathers a child.

For patients with specific conditions, such as congestive heart failure, diabetes or kidney disease, they may not be able to take the medication, or special monitoring tests may be required.

It is always best to inform any treating health care professional that you are taking Lyrica. In case of emergency, it is best to carry an ID card or wear a medical alert bracelet stating that you are taking Lyrica.

Drug interactions
There may be other drugs not listed that can affect Lyrica. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, supplements, and medical prescriptions.

Withdrawal symptoms
It is typical to experience withdrawal symptoms when stopping Lyrica. To avoid or minimize withdrawal symptoms, the treating physician should prescribe a program for reducing the medication over time. In general, Lyrica should be discontinued gradually over one week.

Withdrawal symptoms may include flu-like symptoms, such as:

• Headache
• Sleep problems
• Nausea
• Diarrhea

This medication should be taken exactly as prescribed, following the directions on the prescription label. It should be taken with a glass of water, and may be taken with or without food. It should be taken at the same time every day.

Lyrica should be taken at the prescribed dosage. Patients should never take a double dose if a dose is missed – if it is close to the time for the next dose, skip the missed dose.

Prescription required: Yes

Generic form available: No

FDA approval: June, 2005
Capsules (mg): 25, 50, 75, 100, 150, 200, 225, 300 mg
Maintenance: Lyrica should be stored at room temperature and kept away from moisture or direct light
Information about Lyrica provided by the manufacturer is available at www.Lyrica.com.

• Article written By:
• Judith Frank, MD

April 17, 2008

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