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Anticonvulsant / Neuropathic Analgesic / Anxiolytic

Pregabalin

Brand names: Lyrica

Pregabalin is a gabapentinoid used for peripheral and central neuropathic pain, generalised anxiety disorder and as adjunctive treatment for focal epilepsy.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

For adult indications, begin dosing at 150 mg/day. For partial-onset seizure dosing in pediatric patients 1 month of age and older, refer to section 2.4. ( 2.2 , 2.3 , 2.4 , 2.5 , 2.6 ) Dosing recommendations: INDICATION Dosing Regimen Maximum Dose DPN Pain ( 2.2 ) 3 divided doses per day 300 mg/day within 1 week PHN ( 2.3 ) 2 or 3 divided doses per day 300 mg/day within 1 week. Maximum dose of 600 mg/day. Adjunctive Therapy for Partial-Onset Seizures in Pediatric and Adult Patients Weighing 30 kg or More ( 2.4 ) 2 or 3 divided doses per day Maximum dose of 600 mg/day. Adjunctive Therapy for Partial-Onset Seizures in Pediatric Patients Weighing Less than 30 kg ( 2.4 ) 1 month to less than 4 …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2025-09-23. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It binds to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, reducing the release of excitatory neurotransmitters.

Prescribing in practice

  • Pregabalin is a controlled drug (Class C, Schedule 3) with potential for dependence and misuse; assess risk before prescribing and taper to stop.
  • There is a serious risk of respiratory depression when combined with opioids or other CNS depressants (MHRA warning); use the lowest effective dose and counsel patients and carers.
  • Sedation, dizziness, weight gain and peripheral oedema are common, and the dose should be reduced in renal impairment.

Monitoring

Monitor for sedation, dizziness and signs of respiratory depression, especially when combined with CNS depressants or in renal impairment. Review continued need, response and any signs of dependence or misuse.

Counselling the patient

  • Do not stop taking it suddenly; your dose should be reduced gradually to avoid withdrawal effects.
  • It can make you drowsy or dizzy, especially with alcohol or strong painkillers; do not drive until you know how it affects you.
  • Seek urgent help if your breathing becomes slow or shallow.

Evidence & guidelines

Guideline-recommended for neuropathic pain (NICE CG173); MHRA warning on respiratory depression with concomitant CNS depressants.

Reference: NICE CG173 (Neuropathic Pain); MHRA Drug Safety Update 2017; AGS Beers Criteria 2023; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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