Taking Lyrica (Pregabalin) With Altace (Ramipril)

In our latest question and answer, the pharmacist discusses taking Lyrica (pregabalin) with Altace (ramipril).

Dec 31, 2017

bex asked

Can I take Ramipril and Lyrica at the same time? My dr. prescribed, but when I looked it up online, some sites indicated serious contraindications. Please let me know. Thank you.

Answer

There is considered to be a moderate to major interaction between Lyrica (pregabalin) and Altace (ramipril), an ACE-inhibitor. In fact, it is recommended to use caution when combining Lyrica with ANY ACE-Inhibitor due to the potential of additive/synergistic adverse reactions.

Both Lyrica and ACE-Inhibitor medications, such as ramipril, are associated with a rare but serious side effect known as angioedema. Angioedema is the massive swelling of the dermis (a lower layer or skin) and mucus membranes. It typically occurs most prominently in the facial area (most commonly in the mouth/eyes area) but can also affect the upper body and extremities. Angioedema can also cause swelling of the tongue and upper airways, potentially causing serious or fatal respiratory distress. Below, we list the common symptoms associated with an angioedema reaction:

ACE-Inhibitor/Lyrica Angioedema Symptoms
  • Swelling of the eyes
  • Swelling of the lips
  • Swelling of the tongue
  • Itching
  • Respiratory distress
  • Hives
  • Decreased sensation in areas of swelling

Angioedema has been estimated to occur in about 1-3% of patients taking Lyrica. The incidence of angioedema in those taking ACE-Inhibitors appears to be slightly lower, occurring in about 0.7-1% of patients.

It is unknown exactly how much the combination of Lyrica and ramipril increases the risk of angioedema occurring. The combination has been used successfully and if the drugs must be used together, it is recommended patients are closely monitored for signs and symptoms of angioedema.

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