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Anticonvulsant / Neuropathic Pain

Pregabalin

Brand names: Lyrica

Pregabalin is a gabapentinoid used for neuropathic pain, generalised anxiety disorder, and as an adjunct in 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 the alpha-2-delta subunit of voltage-gated calcium channels, reducing release of excitatory neurotransmitters.

Prescribing in practice

  • It is a controlled drug with recognised misuse potential; taper when stopping rather than stopping abruptly.
  • Sedation and dizziness are common; reduce the dose in renal impairment, as it is renally cleared.
  • There is additive respiratory depression with opioids and other sedatives.

Monitoring

No routine blood monitoring; review benefit, sedation, mood and any signs of misuse, and renal function where relevant.

Counselling the patient

  • Drowsiness and dizziness are common at first and usually settle; take care driving until you know how it affects you.
  • Do not stop suddenly.
  • Report low mood or thoughts of self-harm.

Evidence & guidelines

A first-line option for neuropathic pain (NICE CG173) and an option in generalised anxiety disorder.

Reference: NICE NG193; MHRA Controlled Drug Classification 2019; 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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