bee asked
Lyrica for crack in L5 and pain in leg: I’m having the side effect of drowsy which roll over to next day an not sure if it is palpitations, feeling mild chest discomfort after medication. should I continue or switch to Gabapentin?
Answer
Lyrica (pregabalin) and gabapentin are similar medications in terms of their uses, efficacy and side effect profile. It is a common misconception that gabapentin is the generic of Lyrica. This is not the case however. Gabapentin is the generic of a different medication, Neurontin. Nevertheless, the chemical structures of Lyrica and gabapentin are nearly identical to one another.
The main difference between the two medications is that Lyrica is more potent, and lasts longer per dose than gabapentin. Therefore, lower doses and longer dosing intervals are generally seen with Lyrica. This is easily seen when looking at the recommended dosing for each.
Lyrica Dosing Recommendation for Neuralgia
- 50mg to 450mg in two to three divided doses per day. Doses up to 600mg per day have been used.
Gabapentin Dosing Recommendation for Neuralgia
- 900mg to 3,600mg in three divided doses per day.
In terms of comparative efficacy, Lyrica and gabapentin are both effective for reducing symptoms of pain. Most studies find negligible difference in terms of which is more effective. Some studies suggest however that Lyrica may be more-so in certain individuals due to its potency and better absorption. At the very least, it is known that Lyrica does tend to have a faster onset of action and doesn't require slow dose titration, as gabapentin does.
In addition, Lyrica was initially thought to have less side effects than gabapentin since the drugs are so similar to one another but Lyrica is dosed in far less amounts. However, this doesn't appear to be the case and the side effects experienced from the drugs will vary by the individual.
We have listed the most common side effects and their incidence rate according to the prescribing information for both drugs below.
Gabapentin Side Effects
- Dizziness (17% to 28%)
- Drowsiness (19% to 21%)
- Impaired movement (1% to 13%)
- Fatigue (11%)
- Peripheral edema (2% to 8%)
- Headache (1% to 8%)
- Weakness (6%)
- Palpitations
Lyrica Side Effects
- Peripheral edema (4% to 16%)
- Dizziness (3% to 45%)
- Drowsiness (10% to 36%)
- Headache (2% to 14%)
- Fatigue (4% to 11%)
- Weight gain (2% to 14%)
- Dry eyes (≤15%)
- Palpitations
As you can see above, the side effect profiles between Lyrica and gabapentin are comparable. It may take some trial and error, as well as switching between the two drugs to determine which is better tolerated for you.
