Anticonvulsant / Neuropathic Pain Pregnancy: C — avoid (cardiac malformations reported in some studies)

Pregabalin

Brand names: Lyrica

Adult dose

Dose: 75mg twice daily, increasing to 150–300mg twice daily over 1 week

Route: Oral

Frequency: Twice daily

Max 600mg/day. Renal: eGFR 30–60 → max 300mg/day; eGFR 15–30 → max 150mg/day; eGFR <15 → max 75mg/day. Dose as single daily dose at lower renal function.

Clinical pearls

Class C controlled drug in UK since 2019 — misuse for recreational sedation is significant problem
Twice daily dosing vs gabapentin three times daily — better adherence
More predictable linear pharmacokinetics than gabapentin
Also licensed for generalised anxiety disorder (GAD) — second-line after SSRIs
Taper when stopping — abrupt cessation causes withdrawal

Contraindications

Class C Controlled Drug — assess misuse risk

Side effects

Dizziness
Somnolence
Peripheral oedema
Weight gain
Blurred vision
Respiratory depression with opioids

Interactions

Opioids — significant respiratory depression risk
Alcohol — CNS depression
Benzodiazepines — additive CNS depression

Monitoring

Renal function (creatinine clearance for dosing)
Weight and oedema
Signs of misuse

Reference: NICE NG193; MHRA Controlled Drug Classification 2019. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Gabapentin · Anticonvulsant / Neuropathic Pain

Pathways