Lyrica: Advanced Neuropathic Pain Management Solution
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Synonyms | |||
Lyrica (pregabalin) is a prescription medication specifically formulated for the management of neuropathic pain, fibromyalgia, and as an adjunctive therapy for partial-onset seizures in adults. Developed through extensive clinical research, it belongs to the class of drugs known as anticonvulsants or antiepileptics, functioning by calming overactive nerves in the brain and spinal cord. Its targeted mechanism offers a specialized approach to chronic pain conditions that are often resistant to conventional analgesics. Healthcare providers rely on Lyrica for its consistent efficacy and well-documented safety profile when used under professional supervision.
Features
- Active ingredient: Pregabalin
- Available in multiple strengths: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, and 300 mg capsules or oral solution
- FDA-approved for neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, spinal cord injury, and fibromyalgia
- Also indicated as adjunctive therapy for partial-onset seizures
- Classified as a Schedule V controlled substance due to potential for abuse
- Rapid absorption with peak plasma concentrations within 1.5 hours
- Linear pharmacokinetics with dose-proportional increases in exposure
Benefits
- Provides significant reduction in neuropathic pain scores compared to placebo
- Improves sleep quality and overall patient-reported outcomes in fibromyalgia
- Reduces seizure frequency when used in combination with other antiepileptic drugs
- Demonstrates rapid onset of action with meaningful pain relief often within one week
- Offers flexible dosing options to accommodate individual patient needs and tolerability
- Supported by extensive clinical trial data involving over 10,000 patients worldwide
Common use
Lyrica is primarily prescribed for the management of neuropathic pain conditions, including diabetic peripheral neuropathy—a painful complication of diabetes characterized by burning, shooting, or stabbing pain in the extremities. It is equally effective for postherpetic neuralgia, the persistent pain that follows shingles (herpes zoster) infection. For patients with fibromyalgia, Lyrica helps reduce widespread pain and improve function. In neurology practice, it serves as an add-on treatment for adults with partial-onset seizures when primary antiepileptic medications provide insufficient control. Off-label uses may include generalized anxiety disorder and certain types of chronic musculoskeletal pain, though these applications require careful risk-benefit assessment by treating physicians.
Dosage and direction
Initiation and titration of Lyrica must be individualized based on clinical response and tolerability. For neuropathic pain associated with diabetic peripheral neuropathy or postherpetic neuralgia, the recommended starting dose is 50 mg three times daily (150 mg/day), which may be increased to 100 mg three times daily (300 mg/day) within one week based on efficacy and tolerability. For fibromyalgia, begin with 75 mg twice daily (150 mg/day) and may increase to 150 mg twice daily (300 mg/day) within one week, with further possible escalation to 225 mg twice daily (450 mg/day) if needed. As adjunctive therapy for seizures, start with 75 mg twice daily (150 mg/day) and increase to maximum of 600 mg/day. Administration should occur with or without food, though consistent timing is recommended. Dosage reduction is necessary for patients with renal impairment, with creatinine clearance serving as the guiding parameter. Abrupt discontinuation should be avoided; taper gradually over at least one week to minimize withdrawal symptoms.
Precautions
Lyrica may cause dizziness and somnolence, potentially impairing ability to drive or operate machinery. Patients should be cautioned about performing hazardous activities until they gain experience with the medication’s effects. Peripheral edema has been observed, particularly in elderly patients and those taking concomitant thiazolidinedione antidiabetic drugs. Weight gain occurs in some patients and should be monitored, especially in those with diabetes or cardiovascular risk factors. Ophthalmological effects including blurred vision require periodic assessment. Patients with a history of drug abuse should be closely monitored due to potential for dependence. Lyrica may cause false-positive urine drug screening tests for amphetamines. Caution is advised when prescribing to patients with congestive heart failure as fluid retention may exacerbate cardiac condition. Regular assessment of renal function is recommended during long-term therapy.
Contraindications
Lyrica is contraindicated in patients with known hypersensitivity to pregabalin or any component of the formulation. Cross-sensitivity with other gabapentinoids may occur. The medication should not be administered to patients with severe renal impairment (creatinine clearance <30 mL/min) without appropriate dosage adjustment. Concomitant use with central nervous system depressants including opioids, benzodiazepines, and alcohol requires extreme caution due to additive effects on respiratory depression and sedation. Lyrica is not recommended during pregnancy unless clearly needed, as human data are limited and animal studies have shown developmental toxicity. Breastfeeding is not recommended during treatment.
Possible side effect
The most commonly reported adverse reactions (occurring in ≥5% of patients and twice the rate of placebo) include dizziness, somnolence, dry mouth, edema, blurred vision, weight gain, and difficulty with concentration/attention. Less frequent but clinically significant side effects may include peripheral edema (up to 8% of patients), ataxia, euphoria, tremor, diplopia, and increased appetite. Serious adverse reactions, though rare, include angioedema, hypersensitivity reactions, rhabdomyolysis, and decreased platelet count. Suicidal ideation and behavior have been reported in patients taking antiepileptic drugs for various indications. Most side effects are dose-dependent and often diminish with continued therapy or dosage adjustment.
Drug interaction
Lyrica demonstrates minimal metabolic drug interactions as it is not significantly metabolized and does not inhibit cytochrome P450 enzymes. However, pharmacodynamic interactions are clinically important. Concomitant use with angiotensin-converting enzyme inhibitors may increase the risk of angioedema. Additive effects on cognitive and motor function occur with opioids, benzodiazepines, antidepressants, and alcohol. Gabapentin may reduce pregabalin absorption when administered concurrently. Oxycodone co-administration increases pregabalin AUC by approximately 13% while pregabalin increases oxycodone AUC by 11%. When discontinuing concomitant antiepileptic drugs, gradual withdrawal is recommended to minimize seizure risk.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should never take a double dose to make up for a missed one. Consistency in dosing is important for maintaining stable drug concentrations, particularly for seizure control. Healthcare providers should educate patients about the importance of adherence to prescribed dosing regimens and develop strategies to minimize missed doses, especially in elderly patients or those with complex medication schedules.
Overdose
Signs of Lyrica overdose may include enhanced pharmacological effects: severe drowsiness, sedation, respiratory depression, and coma. There is no specific antidote for pregabalin overdose. Management should focus on supportive care including maintenance of adequate ventilation, perfusion, and vital functions. Hemodialysis effectively removes pregabalin from the bloodstream (approximately 50% reduction in plasma concentrations over 4 hours) and should be considered in cases of severe overdose, particularly in patients with renal impairment. Gastric lavage may be considered if performed soon after ingestion. Symptomatic treatment for specific manifestations should be instituted as appropriate.
Storage
Store Lyrica capsules and oral solution at room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container with the cap tightly closed to protect from moisture and light. The oral solution should be stored in an upright position. Keep all medications out of reach of children and pets. Properly discard any unused medication after the expiration date or when treatment is completed. Do not flush medications down the toilet or pour them into drainage unless specifically instructed to do so.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Lyrica is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual patient responses may vary, and treatment decisions should be based on the professional judgment of the prescribing physician considering the patient’s complete medical history. Patients should not adjust dosage or discontinue medication without consulting their healthcare provider. The full prescribing information contains complete details regarding indications, contraindications, warnings, and precautions.
Reviews
Clinical studies demonstrate that approximately 50% of patients with diabetic neuropathy experience ≥50% pain reduction with Lyrica compared to placebo. In fibromyalgia trials, patients reported significant improvements in pain, sleep, and fatigue scores. Neurologists report favorable experiences with adjunctive use for partial seizures, particularly in patients who have failed multiple other therapies. Patient-reported outcomes indicate improved quality of life measures, though some note side effects like dizziness and weight gain may impact long-term adherence. Real-world evidence supports maintained efficacy over extended treatment periods with appropriate management of adverse effects.