Pregabalin

How it works

What does pregabalin do?

Pregabalin is related to the calming brain chemical gamma aminobutyric acid (GABA).

It reduces the release of brain chemicals that have a stimulating effect.

Pregabalin is a 'controlled drug'. This means that a prescription for pregabalin must be dispensed within 28 days (you can keep most other prescriptions for six months). This is because pregabalin can be abused and might be sold as a street drug. If you must take it to school, it might have to be locked in a safe place.

How long does pregabalin take to start working?

It can take a little time for pregabalin to start helping with anxiety.

In most clinical trials, researchers saw people getting relief from the symptoms of anxiety by week four of taking pregabalin.

How long will I need to take pregabalin?

Many people take pregabalin for some months to prevent their symptoms from returning.

You and your doctor should discuss how long you need to take pregabalin.

Your doctor needs to know if...

You need to talk to your doctor or pharmacist before starting treatment with pregabalin if you have any of the following:

• problems with your kidneys or liver
• regular constipation (difficulty going to the toilet for a poo)
• problems with your heart
• problems with controlling your use of alcohol or drugs
• seizures (fits)
• diabetes
• problems with your eyesight

Taking pregabalin

You should only take pregabalin as agreed with your doctor.

Make sure that you know your dose. If it is not written on the label, check with your pharmacist or doctor.

You may have to take it two or three times a day.

Your doctor may start you on a small dose, which they will then increase slowly over two to three weeks.

It does not matter what time you take it each day. Choose times that you can always remember. This could be at mealtimes, or when you brush your teeth.

You can take it before or after food.

Swallow the capsule whole, with a drink of water – if you chew it, the taste of the ingredients will be unpleasant.

If you are using the oral solution you may have to use a special syringe and stopper for the bottle to get your exact dose.

What if I miss a dose?

If you remember, take it as soon as possible.

If you forget to take it by the time your next dose is due, just miss it out and start again with the next dose.

Do not take a double dose.

What will happen if I forget to take my pregabalin?

If you forget to take your medicine for a few days, you may start feeling anxious again, and you could have a seizure (fit). Talk to your doctor if this happens to you.

Stopping the use of pregabalin

You will probably get uncomfortable withdrawal symptoms if you stop pregabalin suddenly. It is better to agree stopping with a doctor who will reduce your dose gradually.

These symptoms can be worse if you are taking a high dose of pregabalin or have been taking it for a long time.

This does not mean you are addicted to the medicine; it just means that your brain has become used to having it there and balancing chemicals accordingly.

Some of the symptoms you might get include:

• dizziness or headaches
• finding it hard to get to sleep
• feeling anxious or nervous
• feeling sick or getting diarrhoea (having loose poo)
• sweating a lot
• low mood (feeling depressed)
• flu-like symptoms
• feeling pain
• having seizures (fits)

Go and speak to your doctor if you have missed a few doses or have decided to stop taking your medication. If you slowly reduce your medication, withdrawal symptoms are less likely to occur.

The information on this page was reviewed by the College of Mental Health Pharmacy in March 2020.

Safety headlines

If you have taken more pregabalin than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different.

While taking pregabalin, some people may think about hurting themselves or taking their own lives. You must go straight to hospital with your medicine if you have any of these thoughts.

Pregabalin can also cause other serious side effects: allergic reactions (difficulty breathing, swelling of your face or throat, patchy skin rashes), and other serious symptoms that you can find here. Go to a hospital with your medicine if you get any of these symptoms.

Pregabalin does not mix well with some other medicines and drugs.

Stopping pregabalin suddenly can cause serious side effects. Go to your doctor if you want to stop, or if you are having these effects.

You might feel sleepy or dizzy in the first few days after taking pregabalin. Do not drive a car, ride a bike or operate machines until you see how this affects you.

Use good contraception while you are taking pregabalin. If you take pregabalin while you are pregnant, it may affect the developing baby. Talk to your doctor or midwife about this and get their help.

When to go to the hospital

If you have taken more pregabalin than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately – even if you do not feel any different. Go to A&E. Take your medicine with you to show to the doctors. Tell them how much you have taken. Get a friend to go with you, if you can, just in case you feel ill on the way.

You might get any of the following signs:

• feeling sleepy
• confusion
• agitation
• restlessness

While taking pregabalin, some people may think about hurting themselves or have thoughts of taking their own lives. This can happen to anyone, including people who are under 25. These thoughts may happen or get worse in the first few weeks of taking the medicine. You must go straight to hospital with your medicine if you have any of these thoughts and tell the doctor that you are taking pregabalin. There are other medications you can take instead.

Go to a doctor or hospital straight away if you get any of the following symptoms:

• swelling of your face, lips, tongue, or throat
• any patches of skin rash, including red skin peeling off

When to see your doctor

Contact a doctor straight away if you get any of the following symptoms:

• seizures (fits)
• problems with your eyesight (blurred vision or reduced sight)

Side effects

Some side effects that appear should get better after a few days. If they do not, you should go back to your doctor.

Don't stop taking the medicine until you talk to your doctor, or you may get withdrawal symptoms as well.

Very common side effects from taking pregabalin (affecting more than one in ten people) include:

• dizziness
• feeling sleepy
• headache

Common side effects of taking pregabalin (affecting up to one in ten people) include:

• increased appetite
• weight gain
• feeling very happy
• feeling confused or disorientated
• less interest in having sex, and difficulty getting an erection
• feeling irritable, odd (not like your normal self), clumsy and tired
• difficulty paying attention to things
• forgetting things
• tremor (shaking)
• speaking problems
• feeling drunk or walking in a strange way
• tingling or numb feelings
• having trouble sleeping
• blurred vision, double vision
• vertigo (feeling like things around you are moving or spinning, when they are not)
• problems with balance, which may lead to falls
• dry mouth or sore throat
• constipation (difficulty having a poo) and passing extra wind
• feeling sick and being sick
• having a bloated or swollen gut
• swelling of the body, including fingers and toes
• muscle cramps, joint pains, back pain, pain in arms and legs

There are other side effects that you can get when taking this medicine – we have only included the most common ones here.

Please look at the leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know whether you are getting a side effect from your medicine.

If you do get a side effect, please think about reporting it via the Yellow Card Scheme.

Body

A side effect of pregabalin may be an increased appetite and weight gain.

Talk to your doctor about this if it worries you.

Young people with diabetes who put weight on during treatment with pregabalin may need to change their diabetes medicine dose. See your doctor if this applies to you.

Sleep

Pregabalin may make it difficult for you to get to sleep when you start taking it, and you may have strange dreams.

It can also make you feel very sleepy.

See how it affects you in the first few days. If you feel like a zombie and it is not getting better, go back to your doctor.

Sex and fertility

Sex

Pregabalin can have side effects that might affect your sex life. These include:

• loss of interest in sex
• difficulty getting an erection
• changes in periods, either being heavy and painful or stopping altogether
• breast pain or slight breast growth, regardless of gender

These effects should pass after the first couple of weeks. If they do not, and this is a problem for you, go back to the doctor and see what else you could try.

The good effects of pregabalin may have a positive impact on your sex life as your symptoms settle and you can concentrate on your relationships.

Fertility

There is nothing to suggest that pregabalin causes any problems with fertility

Pregnancy and breastfeeding

Pregnancy

Pregabalin is not seen as a major problem in terms of fertility, but two studies show a slight increase in the risk of malformations. The risk seems to be about 16% higher but is affected by any other medicines you may be taking.  

If you do become pregnant while you are on pregabalin, you should carry on taking the medicine and go back to your doctor as soon as possible, to see if you should stop or change your medicine.

If you and your partner are trying to have a baby, you should go back to the doctor to see if you need a different medicine.

If you and your doctor agree that you will carry on taking pregabalin, you should tell your midwife that you are taking it as well.

Breastfeeding

Pregabalin is passed in small amounts to the baby through breast milk. There should be no reason why you can’t breastfeed if you have a healthy full-term baby.

Please talk to your midwife, doctor or pharmacist if you want to breastfeed while taking pregabalin.

Driving and transport

Taking pregabalin may make you feel tired or dizzy, and may affect your eyesight and balance when you start taking it.

This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus or good balance. It might be best to stop doing these things for the first few days, until you know how it affects you.

Do not worry - most people do these things as normal while taking pregabalin.

School and exams

Try not to take pregabalin for the first time just before your exams.

Taking pregabalin may make you feel tired or dizzy, and may affect your eyesight and your memory when you start taking it.

You should talk to your doctor about any future exams if you are starting pregabalin.

You might decide together to delay starting it until you have done them.

If they are more than a month away, however, you might find that it is better to start pregabalin to improve your motivation to study.

Do not worry - most people take exams as normal while taking pregabalin.

Friends and family

You may want to let your family and friends know you are taking pregabalin so they can support you and help you look out for side effects.

For guidance on this, check out our page on getting support with your medication.

Sport

Pregabalin is not a banned substance in sport.

However, it can affect your vision, your concentration and your balance.

This could cause problems in sports like gymnastics and cycling.

Do not play sports that need a lot of focus and balance until you see how pregabalin affects you.

Do not worry - most people play sports as normal while taking pregabalin.

Alcohol and street drugs

Alcohol

You can continue to drink alcohol while taking pregabalin, but having the two together might make you very sleepy.

So, during the first few days, it might be best to stop drinking alcohol until you see how the medicine affects you.

If you want to drink alcohol, remember that you might be sleepy and make sure you can get home safely.

Street drugs

We do not know how pregabalin mixes with street drugs.

It will probably make the drowsy effect of any other drug worse.

Pregabalin can be misused. Do not pass on your medicines to anyone else.

Prescription medicines

Pregabalin mixes well with most other medicines, but always talk to the doctor if you are taking other medicines with pregabalin.

Tell the pharmacist you are taking pregabalin if you buy medicines (including things you put on your skin) for common illnesses.

References and further reading

For more helpful links and information, have a look at our references and further reading page.