Can You Fill A Change In Dose Of Lyrica Early?

Reese asked

Recently my doctor changed my prescription of Lyrica from 200 mg three times daily to 100 mg six time daily. Can I refill this prescription (early) based upon the dosage guidelines?

Answer

Hi Reece, thank you for your question. I can really only give you a bit of background information based on my personal experience as a pharmacist over the last decade. Only your local pharmacy can provide an absolute answer.

Every state has their own laws and regulations on how early a controlled substance can be filled. Usually every pharmacy has their own individual policy on early refills for medication changes as well. Since I don’t know what state you live in, and I won’t be the pharmacist that fills this prescription, I can only offer you my thought process on it.

First, I imagine that I might reach out to your physician due to the odd dose. Lyrica is most commonly dosed two to three times daily. I’ve definitely never seen six times daily and I don’t quite understand why it would be prescribed this way. Due to how pregabalin is metabolized, 200 mg three times daily should work essentially the same way as 100mg six times daily. I would probably seek clarification before I filled the medication as to why it was being prescribed this way. Perhaps you have a special situation that would necessitate a more frequent dosing, but again, I have not seen Lyrica taken six times daily.

Assuming that I was able to clarify with your physician, there are a lot of situations we need to take into account here, and since I don't know your exact situation, you should check with your filling pharmacy. Nevertheless, let's talk through a few.

I’m making the assumption that it was filled last time with 200 mg capsules and not 2 x 100mg capsules. If it was filled with 2 x 100mg capsules, then you should have enough until you are due for your next fill (since you already have the strength you need on hand). However, if your last prescription was filled with 200 mg capsules, they obviously can't be cut or split, so you would need a separate fill for 100 mg capsules to get the right dose.

The next consideration is timing. If it’s only a few days early from when you would be due for the next prescription, then I probably would fill it without much hesitation but I might be a bit hesitant to fill your new prescription if I just filled the 200mg dose a week or so ago. This is something I'd certanly call the doctor on to make sure they know you would have two supplies of Lyrica on hand if we were to fill the new 100 mg prescription.

From a pharmacist perspective, it also depends on how often you try to refill medications early. If you need to fill a controlled substance a day or two early once in a while, I understand that completely. I’ll request an early refill once in a while out of convenience. However, if you are constantly badgering me to fill a medication early, month after month, then I am probably going to give you a bit less leeway on an early fill. Unless there is a legal reason that I can’t fill it, early fills are at the pharmacists’ discretion. It is always their license and livelihood on the line so check with your local pharmacy and they should be able to give you an accurate date.

In most cases, as long as there is a medical need for something, and we have a discussion with the prescriber, then you should be good to go. For you, it seems you are trying to fill a prescription (Lyrica) that is a different strength, and a different dose. As long as there doesn't appear to be any suspicious patterns, this likely would be okay to fill.