Other name: Lyrica
What is pregabalin used for in MS?
Pregabalin is an anticonvulsant drug used in the treatment of neuropathic or nerve pain associated with a number of conditions including multiple sclerosis. As well as nerve pain and epilepsy, it can also be used to treat generalised anxiety disorder.
How do I take pregabalin?
Pregabalin is taken orally as tablets or a liquid that you drink. It’s usually taken twice or three times a day – either once in the morning and once in the evening, or morning, afternoon and evening. Your doctor will determine the most appropriate dose for you.
Stopping treatment with pregabalin should be handled gradually to avoid withdrawal symptoms.
What side effects could I get with pregabalin?
Pregabalin is generally well tolerated with side effects most commonly reported in trials being headache, drowsiness, dizziness, weight gain and fatigue. The extent of the side effects seems to be related to the size of the dose taken. The degree of dizziness and sleepiness can also be increased if pregabalin is taken with certain medications, such as those containing oxycodone (for pain), lorazepam (for anxiety) or alcohol.
Pregabalin should not be taken during pregnancy or when breastfeeding, unless you are told otherwise by your doctor.
In April 2022, the Medicines and Healthcare products Regulatory Agency (MHRA) strengthened its guidance around avoiding pregabalin during pregnancy. This was as a result of new data from a Nordic observational study which suggests that using pregabalin during pregnancy may slightly increase the risk of major congenital malformations (birth defects). The new guidance states that pregabalin should only be used during pregnancy if the benefit to the patient clearly outweighs the potential risk to the foetus and the patient fully understands the benefits, risks and alternatives, and is part of the decision making process. Where the benefits do outweigh the risks, the lowest effective dose should be used.
If you have a condition that affects your breathing, such as chronic obstructive pulmonary disease (COPD), or you are taking a medicine that affects your breathing, such as an opioid painkiller, then taking gabapentin may cause serious breathing difficulties. If you have concerns about this, discuss them with your doctor.
How does pregabalin work?
It is believed that pregabalin works by calming over stimulated nerve cells, which may be an underlying cause for various types of pain.
From April 2019, the government has announced that pregabalin will be reclassified as a Class C controlled drug under the Misuse of Drugs Act 1971 and be placed in Schedule 3 to the Misuse of Drugs Regulations 2001. This follows concerns over the drug being misused. These law changes mean that it will be illegal to possess pregabalin without a prescription and to supply or sell it to others.
What does this mean for me?
Doctors will still be allowed to prescribe pregabalin, however there are a number of rules that you, your doctor and your pharmacist will need to follow from April 2019. NHS England has published a patient leaflet to explain these changes – we also cover some of them below.
- Doctors will only be able to provide 30 days’ supply of pregabalin on one prescription.
- You will need to request a repeat prescription each month from your GP practice.
- Your GP practice may no longer be able to send your prescription electronically to the pharmacy. This means that you or your representative will need to visit the GP practice each month to collect your prescription and take it to the pharmacy.
- If your GP practice uses the electronic prescription service for controlled drugs, your prescription will be sent to the pharmacy electronically. This system has not yet been rolled out in all GP practices.
- You must collect your medicine from the pharmacy within 28 days of the date on the prescription.
- You’ll need to sign and show proof of your identity when you collect your medicine from the pharmacy.
Do speak to your GP practice if you’re unsure about how to get your next prescription.
- Expert Opinion in Pharmacotherapy 2007;8(17):3035-3041. Summary Pregabalin in the management of central neuropathic pain.
The two main types of pain in multiple sclerosis are nerve (neuropathic) pain and musculoskeletal (nociceptive) pain. Find out more about pain in this A-Z entry.
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How common is nerve pain in early MS?
26 October 2015
Investigating how common nerve or neuropathic pain is in early MS - MS Trust research update.