Pregabalin, Gabapentin

Gaba Analog

  • used with opiod may cause respiratory suppression

Pregabalin (Lyrica)

  • Caution when used with opioid and benzo
  • Excreted from urine 90% unchanged
  • Pregnancy: category C
  • Pregabalin Capsule: 25, 50, 75, 100, 150, 200, 225, 300 mg (generic about $30 for 60 cap)
  • Pregabalin solution: 20 mg/ml
  • Lyrica CR: 82.5, 165, 330 mg ( no generic, $400 for 30 tab)
  • Indications:
    • Fibromyalgia, neuropathic pain, seizure
  • Off label use:
    • Chronic cough, anxiety, pruritus, Restless Leg Syndrome, vasomotor w menopause

Gabapentin (Neurontin)

  • Start dose: 100 to 300 mg hs
  • Target dose: 300 mg to 600 mg qid
  • Max dose: aournd 3,600 mg per day
  • Available in: 100, 300, 400, 600, 800 mg (Generic < $20 per month supply)
  • Indications:
    • neuropathic pain
    • alcohol withdraw
  • Off label use
    • fibromyalgia
    • hiccup
    • pruritis
    • Post op pain
    • restless leg
    • anxiety disorder
    • vasomotor symptoms with menopause
  • Kidney disease
    • take bid or qd, reduce dose
    • end stage renal disease: up to 300 mg /day

UptoDate reviewed on 03/10/2020