Gabapentin vs Pregabalin: which one’s better? That’s one question many individuals ask when deciding between these two medicines. They share many similarities in various ways, making comparisons between them quite challenging.

While Pregabalin and Gabapentin share many similarities, there are a few things that set them apart. In this guide, we will highlight the similarities and differences between these medications to help you choose the right one based on your individual needs.

What Are Pregabalin And Gabapentin?

Pregabalin is a potent medication that belongs to a class of drugs known as anticonvulsants. This versatile medication gained recognition for its numerous therapeutic benefits. It is marketed under different brand names, but the most popular ones are Lyrica and Nervigesic capsules.

Gabapentin is another versatile drug that is used to ease nerve pain and control seizures. This medication has become increasingly popular among healthcare providers and patients due to its diverse uses and effectiveness in treating various health conditions.

Some popular brand names of Gabapentin include Gralise and Neurontin.

Pregabalin Vs. Gabapentin: Differences

Some of the notable differences that set apart Pregabalin and Gabapentin are –

The FDA approves Pregabalin for more uses than Gabapentin.

Gabapentin and Pregabalin are both FDA-approved as an add-on therapy for seizures. But Pregabalin is approved for children as young as 1 month old and adults, whereas Gabapentin is approved for children who are at least 3 years old and adults.

Pregabalin and Gabapentin are also approved for neuropathic pain associated with shingles. Pregabalin has a few more uses, approved by the FDA, including fibromyalgia, nerve pain from diabetes, and spinal cord injuries [1].

Gabapentin and Pregabalin are available in different forms.

Gabapentin and Pregabalin are available as capsules, extended-release (ER) tablets, and oral solution. Gabapentin is available as an oral solution, capsule, tablet, and extended-release tablet.

Pregabalin Vs Gabapentin: Dosage

Pregabalin is usually administered twice daily, although the ER (extended-release) tablet is taken once daily.

The medication is available in dosage forms:

Capsules: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, 300 mg.

Extended-Release Tablets: 82.5 mg, 165 mg, 330 mg.

Oral Liquid: 20 mg per milliliter.

Whereas, Gabapentin is usually taken two to three times a day. However, the extended-release tablet form of the medication may be given only once daily. Gabapentin is available in the following dosage forms.

Tablets: 100 mg, 300 mg, 400 mg, 600 mg, 800 mg

Extended-Release Tablets: 300 mg, 600 mg

Oral Liquid: 250 mg per 5 milliliters

Capsules: 100 mg, 300 mg, 400 mg

Gabapentin Vs Pregabalin – Side Effects

Drowsiness and dizziness are the most common side effects associated with Pregabalin and Gabapentin. Other side effects include dry mouth, vision problems, and fluid buildup in the legs and arms.

One adverse effect that’s more common with Pregabalin use is weight gain, but weight gain does not seem to be associated with Gabapentin use.

Pregabalin is a controlled substance, but it is only controlled in some states.

The federal Drug Enforcement Agency lists Pregabalin as a Schedule V controlled substance. This means this medication is considered a controlled substance in every State. In contrast, Gabapentin is not considered a controlled substance by the DEA. It is only considered a Schedule V substance in some States [2].

When a drug is classified as a controlled substance, it means it has a higher risk of misuse and dependence. Schedule V controlled medications are considered to pose the lowest risk compared to other controlled substances.

Pregabalin is absorbed faster than Gabapentin.

Pregabalin is absorbed more quickly and begins to show its effects more rapidly than Gabapentin. Pregabalin reaches its peak concentrations within an hour of intake, whereas it takes 3 to 4 hours for Gabapentin to reach its peak concentrations [3].

Drug Interactions

Both Pregabalin and Gabapentin can interact with alcohol as well as other medications.

Note: This may not be a complete list of all the drug interactions of Pregabalin and Gabapentin. Consult a healthcare professional about all the medications you may be taking.

Similarities Between Pregabalin And Gabapentin

Some of the similarities between Pregabalin and Gabapentin are –

Working mechanism

Both Gabapentin and Pregabalin work similarly by binding to a calcium channel in the central nervous system (CNS). This binding decreases calcium influx into nerve cells, thereby reducing the release of excitatory neurotransmitters. This helps decrease neuronal excitability, aiding in pain management and seizure control.

If you are interested in learning about the mechanism of action of Pregabalin in detail, please visit our comprehensive blog page on this subject.

FDA Approval

Pregabalin and Gabapentin are both approved by the US FDA. Pregabalin was approved for medical use in 2004, whereas Gabapentin use was approved in 1993 by the FDA [4] [5].

Withdrawal Symptoms

Abrupt discontinuation of either drug can lead to withdrawal symptoms, including nausea, seizures, insomnia, and anxiety.

Gabapentin Versus Pregabalin: Which Drug Lasts Longer?

The table below compares the half-life of Pregabalin and Gabapentin. It takes about five half-lives (the time taken by a drug’s active substance to reduce by half) to clear a medication from your system [6].

Based on their half-lives, the therapeutic benefits of Pregabalin last for 8 to 12 hours, and those of Gabapentin last for 5 to 7 hours [7] [8].

Lyrica vs. Gabapentin: Effectiveness

Numerous clinical trials have examined which of Pregabalin and Gabapentin is more effective for treating specific conditions. Some of the findings are explained below [9].

Pregabalin Vs. Gabapentin for Anxiety

Neither Gabapentin nor Pregabalin is the first-line treatment for anxiety. However, in some cases, experts say Pregabalin can be used at a daily dose of 150-600 mg for anxiety. Gabapentin, in contrast, is not recommended therapy.

Pregabalin Vs. Gabapentin For Fibromyalgia

Pregabalin is one of the primary treatments often used with non-drug therapies to treat fibromyalgia. It has been studied at a daily dose of 450 mg to treat the condition. Although Gabapentin has also been studied for this condition, its use is currently limited to research.

Pregabalin Vs. Gabapentin: Which Is Better For Nerve Pain?

Both Gabapentin and Pregabalin are prescribed to treat different causes of nerve pain, including diabetic nerve pain and post-shingles. Although a study by Victor Mayoral et al. Pregabalin is more potent in alleviating neuropathic pain than Gabapentin is.

Is It Okay To Take Pregabalin and Gabapentin Together?

No, it is not recommended to combine Gabapentin and Pregabalin as this combination can exaggerate adverse effects, such as dizziness and sleepiness. This, in turn, can increase your risk of falls and accidents. In some cases, this combination can also lead to breathing issues [10] [11].

Switching Between Gabapentin And Pregabalin

According to a research study, when people switched from Gabapentin to Pregabalin, they experienced better pain control. This was seen in both patients who responded well to Gabapentin and those who did not respond well to the medication. Pregabalin helped manage pain more effectively than Gabapentin.

A study by Masataka Ifuku and colleagues, published in 2011, found that Pregabalin is six times more potent than Gabapentin for pain management.

Pregbalin Vs. Gabapentin: Precautions and Warnings

• In case you overdose on either Gabapentin or Pregabalin, seek immediate medical attention.
• Both these medications should be avoided by breastfeeding and pregnant mothers.
• If you have any kidney or liver issues, refrain from taking these medications without consulting a doctor.
• Both Pregabalin and Gabapentin may cause dizziness and drowsiness. This may make it difficult to perform everyday tasks that require full alertness, such as driving.
• Both these medications can be consumed on an empty stomach or with food.
• Do not cut, crush, or split Gabapentin or Pregabalin, and follow all administration guidelines written on the medication leaflet.
• Store these medications at room temperature away from heat and moisture.

Conclusion

Pregabalin and Gabapentin are both effective medications with numerous therapeutic benefits. The decision to use either of them should be made during a consultation with your healthcare provider. A healthcare professional will take into account your age, symptoms, medical history, and other factors before prescribing either of these two.

If you are prescribed either medication, always take it according to your healthcare provider’s instructions and never share your prescription with anyone else.