Lyrica vs Gabapentin

Name: Lyrica vs Gabapentin

What is Lyrica? What is gabapentin? How do they work?

Gabapentin is an anti-seizure (anti-convulsant) drug that is used for preventing seizures and for treating post-herpetic neuralgia, the pain that follows an episode of shingles. Doctors do not know how gabapentin works. Gabapentin structurally resembles the neurotransmitter gamma aminobutyric acid (GABA). It is possible that this similarity is related to gabapentin's mechanism of action. In animal models used for testing the anticonvulsant and analgesic (anti-pain) activities of drugs, gabapentin prevents seizures and reduces pain-related responses.

Lyrica (pregabalin) is an oral medication that is chemically related to gabapentin (Gralise, Neurontin). It is used for treating pain caused by neurologic diseases such as postherpetic neuralgia as well as seizures. It also is used for treating fibromyalgia.

What are the side effects of Lyrica vs. gabapentin?

Lyrica side effects

SIDE EFFECTS WARNING: Antiepileptic medications have been associated with increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.

The most common side effects of Lyrica include:

  • dizziness,
  • drowsiness,
  • dry mouth (xerostomia),
  • edema (accumulation of fluid),
  • blurred vision,
  • double vision (diplopia),
  • weight gain,
  • fatigue (tiredness),
  • abnormal gait (ataxia),
  • tremor, and
  • difficulty concentrating.

Other side effects include

  • constipation,
  • increased appetite,
  • nausea,
  • flatulence,
  • amnesia,
  • disorientation,
  • myoclonus (sudden, involuntary jerking of a muscle or muscle groups),
  • heart failure,
  • low blood pressure,
  • vomiting,
  • reduced blood platelet counts, and
  • increased blood creatinine kinase levels.

Increased creatinine kinase can be a sign of muscle injury, and in clinical trials three patients experienced rhabdomyolysis (severe muscle injury). Therefore, patients should report unexplained muscle pain, tenderness or weakness to their doctors, especially if associated with fever and malaise (reduced well-being). Lyrica has rarely been associated with angioedema (swelling of the face, tongue, lips, and gums, throat and larynx).

Gabapentin side effects

The most common side effects of gabapentin are:

  • Dizziness
  • Sleepiness
  • Ataxia
  • Fatigue
  • Drowsiness
  • Fluid retention (edema)
  • Hostility
  • Nausea
  • Vomiting
  • Difficulty speaking
  • Jerky movements
  • Unusual eye movements
  • Double vision
  • Tremors
  • Memory loss
  • Unsteadiness

Other adverse effects and serious side effects associated with gabapentin include:

  • Weight gain
  • Joint pain
  • Motion sickness
  • Blurred vision
  • Viral infection

Antiepileptic medications have been associated with an increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.

What drugs interact with Lyrica vs. gabapentin?

Lyrica drug interactions

  • Alcohol and drugs that cause sedation may increase the sedative effects of pregabalin.
  • Pioglitazone (Actos) and rosiglitazone (Avandia) cause weight gain, fluid retention, and possibly heart failure. Therefore, combining pregabalin with these drugs may increase the occurrence of weight gain and fluid retention.

Gabapentin drug interactions

  • Antacids reduce the concentration of gabapentin in blood. Therefore, gabapentin should be administered 2 hours or more after taking antacids.
  • Morphine significantly increases blood concentrations of gabapentin and may increase central nervous system-related adverse events associated with gabapentin.

Are Lyrica or gabapentin safe to take if I am pregnant or breastfeeding?

Lyrica safety

  • There are no adequate studies of Lyrica in pregnant women.
  • It is not known whether Lyrica is excreted in breast milk.

Gabapentin safety

  • Doctors do not know the safety of gabapentin during pregnancy.
  • Gabapentin is secreted in human breast milk; therefore, if you are pregnant you should only use this medication if the benefits outweigh the unknown risk to the fetus.

Summary

Lyrica and gabapentin are drugs used to prevent seizures and to treat nerve pain associated with various conditions, for example, shingles. Lyrica and gabapentin are chemically related, but researchers do not know exactly how they work. Gabapentin also has several off-label uses to treat other conditions that cause pain, and substance abuse withdrawal.

Both pain medications also treat fibromyalgia. Off-label uses (non-FDA approved) for gabapentin are hot flashes, hiccups, restless leg syndrome (RLS), hyperhidrosis (excessive sweating), headaches, and diabetic neuropathy. Lyrica also treats pain associated with spinal cord injuries.

Lyrica and gabapentin both cause similar side effects, for example, tremors, blurred or double vision, memory or concentration problems, dizziness, and drowsiness.

Side effects of Lyrica that are different from gabapentin include constipation, weight gain, dry mouth, constipation, breast enlargement, and edema (swelling). Side effects unique to gabapentin include viral infections, fever, speech problems, unusual eye movements, and jerky movements.

The generic name for Lyrica is pregabalin. Gabapentin is available in the US under the brand names Neurontin, Gralise, Horizant, Fanatrex, and FusePag.

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