Tamnel asked
I currently take Lyrica 25 mg 3x a day how does this convert to Lyrica CR?
At a glance
- Converting from immediate-release Lyrica to Lyrica CR (extended release) is easy. Simply calculate your total daily dose and use the provided conversion chart to find your once-daily dose of Lyrica CR.
Answer
The manufacturer of Lyrica CR (pregabalin extended-release) recommends calculating the total daily dose of the immediate release formulation when switching to the extended-release formulation.
For example, taking Lyrica 25 mg three times a day equates to a total daily dose of 75 mg.
Using the conversion chart provided in the package insert, the recommended dose would be 82.5 mg once per day.
One the first day of switching from immediate-release Lyrica to Lyrica CR, Pfizer recommends taking the morning dose of Lyrica as prescribed, followed by starting Lyrica CR the same evening. Per the prescribing information:
"When switching from LYRICA to LYRICA CR on the day of the switch, instruct patients to take their morning dose of LYRICA as prescribed and initiate LYRICA CR therapy after an evening meal."
Other conversions can be seen in the chart below:
About Lyrica CR
Lyrica CR (pregabalin extended-release) was approved by the FDA in October of 2017. The drug manufacturer, Pfizer, also manufactures Lyrica capsules, which have been on the market since 2004. There are two primary differences between Lyrica and Lyrica CR:
- First, Lyrica CR is not FDA approved for the treatment of fibromyalgia, unlike Lyrica.
- Second, Lyrica CR is approved to be taken once daily instead of twice or thrice daily.
Pfizer was motivated to produce a new formulation of Lyrica because generic versions of Lyrica are expected to be on the market in 2019. This will significantly reduce the market share for Pfizer’s product due to the enhanced competition and undercutting of the price.
Creating an extended-release version of Lyrica allows them to give patients a reason to stick with one of the branded products since it will allow for improved convenience and patient compliance. Some patients find it difficult to remember to take medications multiple times a day.
While Lyrica CR is approved for the other indications like neuropathic pain associated with diabetic peripheral neuropathy and postherpetic neuralgia, it is not approved for the treatment of fibromyalgia. This is due to the type of study that was used to approve this version of the medication.
So far, Lyrica CR was only studied in patients with postherpetic neuralgia. The FDA also granted approval for diabetic peripheral neuropathy since both conditions are similar.
Video Summary
References
- Elsevier ClinicalKey: Lyrica Monograph (Accessed 1/11/19)
- Pfrizer Press Release (Accessed 1/11/19)
- Lyrica Manufacturer Website (Accessed 1/11/19)
- Lyrica Prescribing Information. Link (Accessed 1/11/19)
- Efficacy and Safety of Once-Daily Controlled-Release Pregabalin for the Treatment of Patients With Postherpetic Neuralgia: A Double-Blind, Enriched Enrollment Randomized Withdrawal, Placebo-Controlled Trial. PubMed (Accessed 1/11/19)
