Gabapentin vs Pregabalin: What You Need to Know

Neuropathic pain, also referred to as nerve pain, is chronic pain that develops when the nervous system is damaged or not working correctly due to disease or injury. 

While there is no cure, treatment options can help manage symptoms and prevent or lessen problems, including prescription medications. 

Two of the most common medicines prescribed for neuropathic pain are Gabapentin and Pregabalin (Lyrica). 

So what are the main differences between these drugs? Which one is more effective at managing nerve pain? How similar are they? We put together this guide to compare Gabapentin and Pregabalin to help you (along with your physician) make the right decision for your treatment plan.

Similarities of Gabapentin and Pregabalin

Gabapentin and Lyrica both belong to the gabapentinoids class of medicines. Therefore, they have many similarities, such as:

The way they work: 

While there is more to be discovered to fully understand how these medications work, t's believed that they are both structurally identical to the neurotransmitter gamma-aminobutyric acid (GABA). 

Though they contain different active ingredients, Gabapentin and Lyrica work similarly to slow down nerve signals. 

Treatment options for animals

Even though neither medication is FDA-approved for animals, more and more veterinarians prescribe Gabapentin or Pregabalin for use in certain medical conditions in dogs and cats. 

Risk of withdrawal symptoms 

Experts agree that to reduce your chances of withdrawal symptoms, you should always taper off Gabapentin and Pregabalin. Your doctor can help determine the proper tapering schedule for you.

Withdrawal symptoms from either medication may include:

• fatigue

• vomiting

• diarrhea

• sweating

• anxiety

• insomnia

Dosage 

The amount of medication and how often you take it will depend on the condition you are being treated for and the form of the prescribed medicine. Always follow the instructions given by your prescribing physician. 

Both Gabapentin and Pregabalin are available as a capsule, a tablet, an extended-release, or an oral solution (liquid) taken by the mouth. 

How are Gabapentin and Lyrica Different?

While Gabapentin and Pregabalin share many similarities, they are also very different. 

What they treat:

Both anti-seizure medications (anticonvulsants) were created for people with epilepsy. 

Lyrica is approved to treat seizures, complications from shingles, restless legs syndrome, diabetic peripheral neuropathy, and pain associated with  fibromyalgia.

In addition to the above conditions, Gabapentin is also used for many off-label uses, like:

• insomnia

• periodic limb movement disorders (PLMDs) 

• vertigo

• itchy skin

• anxiety

• bipolar disorder (BPD)

• menopausal symptoms 

• migraines

Side Effects

Both medications have the potential for similar side effects, such as dizziness, fatigue, loss of balance, memory or concentration issues, tremors, and vision problems. 

Common side effects of Gabapentin include:

• difficulty speaking

• fever

• nausea and vomiting

• an increased risk of recurring infections

• unusual eye movements

• jerky movements

Common side effects of Lyrica:

• dry mouth

• constipation

• edema (swelling in the arms, hands, legs, and feet)

• weight gain

Interactions with other drugs

Although both medications have comparable drug interactions, Gabapentin can have adverse reactions when combined with certain NSAIDs, such as ibuprofen.

Lyrica and Gabapentin are also not meant to be taken together, nor are they interchangeable. 

Mixing alcohol with Gabapentin or Pregabalin can worsen some side effects, like dizziness and drowsiness. 

Always consult your healthcare provider before starting any new medication to learn more about potential drug interactions. 

Effective rate

Lyrica reaches its peak drug concentration within an hour of being taken because it's absorbed faster. However, Gabapentin can take up to 4 hours to reach its peak concentration. 

Classification as controlled substances

Lyrica is classified as a Schedule V controlled substance by the Drug Enforcement Administration (DEA) because of its potential for abuse and physiological dependence. 

While not classified at the Federal level, Gabapentin is considered a controlled substance at the state level in Kentucky, Virginia, West Virginia, Michigan, and Tennessee. Minnesota, Ohio, Illinois, Massachusetts, and Wyoming all use Prescription Drug Monitoring Programs(PDMPs) to track Gabapentin usage. 

If you or a loved one are struggling with drug or alcohol abuse, help is available! Please contact the Substance Abuse and Mental Health Administration by visiting their website or calling 1-800-662-HELP (4357). 

Costs for medications 

Both medications are only available with a prescription from a healthcare provider. 

Lyrica and Lyrica CR are the brand names of Pregabalin, whereas Gabapentin is generic for Gralise, Neurontin, and Horizant. 

The cost of each medication will depend on your insurance pharmacy coverage. If you don't have insurance or want to compare prices using a prescription discount card, Carecard.com can show you how much particular medication costs at pharmacies near you. 

When this article was written, Gabapentin and Pregabalin had about a $3 cost difference between the generic versions of these medications. 

At CareCard, we are passionate about helping make your prescription payments more affordable, saving members up to 85% on prescription drugs and medications. Learn how CareCard can help make your medication payments more manageable.