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Pregabalin vs Gabapentin

Both pregabalin and gabapentin are drugs prescribed to treat nerve pain, seizures, and anxiety disorders, but these two drugs are not the same. There are significant differences between the two, and it is important that you do not take medication that is not prescribed to you, even if the medication has been designed to treat the same conditions.

Here’s what you need to know when comparing pregabalin vs. gabapentin:

Pregabalin vs Gabapentin: What are They and How Do They Work?

Pregabalin and gabapentin are medications that are primarily prescribed in the treatment of nerve pain and seizure disorders. These drugs work by blocking certain brain signals that are responsible for pain perception. Pregabalin is a newer drug and is considered a stronger version of gabapentin, which means it works more efficiently at lower doses. However, these drugs have different chemical structures and are not suitable for all individuals.

Brand names of gabapentin include Horizant®, Gralise® and Neurontin®. Brand names of pregabalin include Lyrica® and Lyrica CR®.

What Conditions are Treated With Pregabalin and Gabapentin?

Pregabalin and gabapentin are both primarily used to treat nerve pain, seizures disorders, and related conditions, although they may also be used for off-label indications.

Conditions commonly treated with pregabalin [1]:

  • Neuropathic pain associated with diabetic peripheral neuropathy
  • Postherpetic neuralgia (nerve pain caused by shingles)
  • Fibromyalgia
  • Generalized anxiety disorder (GAD)
  • Partial onset seizures in adults

Conditions commonly treated with gabapentin [2]:

  • Neuropathic pain associated with diabetic peripheral neuropathy
  • Postherpetic neuralgia
  • Epilepsy (as adjunctive therapy for partial seizures)

Off-label uses of gabapentin include the treatment of Generalized anxiety disorder (GAD) and Fibromyalgia.

Are Pregabalin and Gabapentin Interchangeable?

Gabapentin and pregabalin are metabolized by the body in different ways. For those with liver or kidney conditions, it is important that proper precautions be taken. Before you take either of these medications, speak with your doctor if you have had any previous issues with your liver or kidneys.

Side Effect Pregabalin Gabapentin
Dizziness Yes Yes
Drowsiness Yes Yes
Weight gain Yes Rare
Edema (swelling) Yes Rare
Dry mouth Rare Yes
Headache Yes Yes
Nausea Yes Yes
Diarrhea Yes Yes
Blurred vision Yes Yes
Fatigue Yes Yes
Cognitive impairment Yes Yes
Tremors Yes Yes
Mood changes Yes Yes
Suicidal thoughts Rare Rare
Allergic Reactions Rare Rare

This is not a complete list of potential side effects of pregabalin vs. gabapentin. Every individual is different and may experience side effects that are not on this list. If you have been taking either of these drugs and are experiencing unexpected side effects, contact your medical provider.

Can You Get Addicted to Gabapentin and Pregabalin?

Both gabapentin and pregabalin have the potential to result in physical and psychological dependence. This risk increases significantly if these drugs are used in high doses or over long periods of time.

Individuals with a history of substance abuse disorders or addiction may be at an increased risk of developing dependence on these gabapentin and pregabalin.

Addiction Treatment for Gabapentin and Pregabalin
Addiction and substance abuse can happen to anyone. Whether you’ve been prescribed pregabalin or gabapentin or you’ve been taking it recreationally, it is possible to develop a substance dependence.

Frequently Asked Questions About Pregabalin vs. GabapentinFrequently Asked Questions About Pregabalin vs. Gabapentin

Below, we have answered some of the most common questions we get about pregabalin vs. gabapentin

Can Gabapentin and Pregabalin be Used Together?

In unique cases, gabapentin and pregabalin may be prescribed together if a medical professional deems it safe and necessary. However, taking these medications together may increase the risk of certain side effects, such as dizziness, drowsiness, and cognitive impairment, as well the risk of developing dependence or addiction.

Pregabalin vs. Gabapentin: Medication Interactions

Medication Gabapentin Pregabalin
Alcohol Risk of central nervous system and respiratory depression Risk of central nervous system and respiratory depression
Antacids Decreased absorption No significant interaction
Benzodiazepines Risk of central nervous system and respiratory depression Risk of central nervous system and respiratory depression
Cimetidine Increased plasma concentration Increased plasma concentration
Diuretics No significant interaction Increased risk of edema (swelling)
Diabetes or high blood pressure medications No significant interaction Potential interaction
Morphine Increased sedation and dizziness Risk of respiratory depression
Naproxen Increased risk of kidney damage No significant interaction
Hydrocodone Risk of respiratory depression No significant interaction
Opioids Risk of central nervous system and respiratory depression Risk of central nervous system and respiratory depression
Oxycodone No significant interaction Increased risk of respiratory depression
Aceclofenac Increased risk of kidney damage No significant interaction
Thiazolidinediones No significant interaction Increased risk of edema (swelling) and heart failure

Important: This is not an exhaustive list of medication interactions. Speak with your doctor or pharmacist before taking pregabalin or gabapentin about any potential interactions.

Are Gabapentin and Pregabalin Safe When Pregnant or Breastfeeding?

Gabapentin and pregabalin are both classified as Pregnancy Category C drugs by the FDA, which means that there are no satisfactory studies in women during pregnancy, but that animal studies demonstrated a potential risk to the fetus. The potential benefits may outweigh the risks in certain cases, which will be determined by your doctor. Gabapentin and pregabalin have been detected in human breast milk, however the effects of the substances in nursing infants are not well established.

Pregabalin vs. Gabapentin: Withdrawal Symptoms

If stopped taking abruptly, both gabapentin and pregabalin can cause withdrawal symptoms. However, it is generally accepted that pregabalin has a lower risk of withdrawal symptoms as compared to gabapentin. Withdrawal symptoms associated with gabapentin include: Anxiety Insomnia Nausea Sweating Seizures Withdrawal symptoms associated with pregabalin include: Anxiety Insomnia Sweating Muscle aches Withdrawal symptoms of gabapentin are typically more severe than that of pregabalin, however, it is still important to detox from both substances under the supervision of a medical professional to mitigate any risks.

Can You Drink Alcohol When Taking Pregabalin or Gabapentin?

Consuming alcohol while taking gabapentin or pregabalin can increase the risk of dizziness, drowsiness, and other side effects associated with these medications. It is recommended that those taking either of these substances abstain from drinking alcohol.
[There are conflicting evidence to whether pregabalin or gabapentin has a lower risk of tolerance. It is beyond the scope of this article. Additionally, this applies to pregnancy [3] use.]

How Do You Get Help for Someone Who is Abusing Pregabalin or Gabapentin?

If you or someone you know is abusing pregabalin or gabapentin, it is important to seek help as soon as possible. Abuse of these drugs can lead to severe health concerns and can even be fatal.

Contact a member of the Oceans Recovery team to learn more about your treatment options for gabapentin or pregabalin abuse.

Sources:

[1] Cross, A. (et al). National Center for Biotechnology Information. (2022, November 14th). Pregabalin. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470341/ on 2023, April 10.
[2] U.S. Food and Drug Administration. (2011, August 8). Neurontin® (gabapentin) Capsules, Neurontin® (gabapentin) Tablets, Neurontin® (gabapentin) Oral Solution. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/020235s050,020882s035,021129s033lbl.pdf on 2023, April 10.
[3] Leek, J. Arif, H. National Center for Biotechnology Information. (2022, July 25). Pregnancy Medications. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK507858/ on 2023, April 10.

Last medically reviewed April 19, 2023.