Key Points

  • Lyrica and gabapentin are both gabapentinoids.
  • Both medications are used to treat nerve pain and seizures.
  • Both medications have differing off-label uses, including alcohol withdrawal syndrome.
  • Both medications are approved by the U.S. Food and Drug Administration (FDA).

When it comes to prescription drugs for treating neuropathic pain, gabapentin and Lyrica are the most frequently mentioned. Despite their similarities, these two medications have several differences. This might lead you to wonder when it’s appropriate to use one instead of the other or if they can be used interchangeably.

Here, you’ll learn how the two medications work, how they differ, and when it’s best to choose one over the other.

What Kind of Drug is Lyrica?

Lyrica is the brand name for the generic drug pregabalin. This medication belongs to the drug class gamma-aminobutyric acid analogs.[1] They work by slowing down impulses in the brain that can lead to seizures. They also affect chemicals in the brain that send pain signals throughout the central nervous system. In 2004, Lyrica was given FDA approval for the treatment of neuropathic pain and seizures.[2]

Lyrica is also used to treat:[3]

  • Neuropathic pain associated with diabetic peripheral neuropathy.
  • Neuropathic pain associated with spinal cord injury.
  • Neuropathic pain originating from postherpetic neuralgia.
  • Adjunctive treatment for partial-onset seizures in epileptics
  • Fibromyalgia

Pregabalin also has several off-label uses, which include treating generalized anxiety disorder, social anxiety disorder, chronic pain conditions, restlessness, and trigeminal neuralgia.[3] Individuals suffering from chronic cough or insomnia may also be prescribed pregabalin as an initial treatment.

What is Gabapentin?

Gabapentin is a generic medication from the gamma-aminobutyric acid analogs class of drugs.[4] Scientists aren’t entirely sure how this medication works. However, it has been observed to decrease abnormal activity in the brain that can lead to seizures. It also reduces the response to painful stimuli.[4]

According to StatPearls, gabapentin was FDA approved in 1993 to treat the following conditions:[5]

  • Partial seizures and individuals with epilepsy
  • Restless leg syndrome
  • Postherpetic pain

Gabapentin is sold under the brand names: Horizant, Neurontin, Gabarone, and Gralise.[6] Each formulation treats a different type of pain.

  • Neurontin treats postherpetic nerve pain.
  • Gralise treats shingles
  • Horizant treats restless leg syndrome.

This medication can also be used off-label to treat conditions including alcohol withdrawal syndrome, anxiety, depression, and movement disorders, including amyotrophic lateral sclerosis (ALS).[5]

How are Gabapentin and Lyrica Administered?

Both gabapentin and Lyrica are administered orally. However, their doses differ.

  • Gabapentin:[5] Capsules are available in strengths of 100 mg, 300 mg and 400 mg. Tablets are available in strengths of 600 mg and 800 mg. The oral solution is available in a dose of 250 mg/ 5mL.
  • Lyrica:[7] Capsules are available in doses of 25 mg, 50 mg, 75 mg, 100 mg,150 mg, 200 mg, 225 mg, and 300 mg. Extended release tablets are available in strengths of 82.5 mg, 165 mg, and 330 mg. The oral solution is available in one strength, 20 mg/mL.

Gabapentin and Lyrica Administered

What are the Similarities Between Gabapentin and Lyrica?

Gabapentin and Lyrica share several similarities that extend beyond their generic prefix ‘gaba’.

  • Both are anticonvulsants
  • They are both gabapentinoids [8]
  • Both treat nerve pain and seizures
  • Both treat restless leg syndrome as an off-label solution
  • Both are available in capsule, tablet, and oral solution formulations
  • Both decrease overactivity in the brain
  • Both received FDA approval
  • Both require a gradual taper method to discontinue use
  • Both are considered Schedule V Controlled Substances (though only in a few states in the case of gabapentin) [9][10]
  • Both share common side effects, such as dizziness, drowsiness, and weight gain

How Do Gabapentin and Lyrica Differ?

Lyrica and gabapentin are anticonvulsants used to treat similar conditions. However, despite their similarities, they differ in many ways.

The following list demonstrates how Lyrica and gabapentin differ:[11]

  • Gabapentin is taken 3 to 4 times a day, while Lyrica is taken three times per day.
  • Gabapentin can be used to manage alcohol withdrawal syndrome, but this is not an acceptable use for Lyrica.
  • Lyrica is federally controlled in all states, and gabapentin is only federally controlled in some.
  • Lyrica is more likely than gabapentin to cause constipation, dry mouth, and swelling.
  • The maximum daily dosage is 600 mg, whereas gabapentin is 3600 mg.
  • Lyrica has a potential for abuse, while gabapentin does not.
  • Lyrica absorbs quickly than gabapentin.
  • Gabapentin is less costly than Lyrica.
  • Gabapentin has more uses than Lyrica.

When Should One Be Prescribed Over the Other?

Although both drugs belong to the same class and have similar mechanisms of action, there are times when a physician will want to prescribe one over the other. The reasons for choosing one medication over the other include the following:

  • Lyrica would be less suitable for individuals struggling with addiction as it is habit-forming.
  • Those who are paying out of pocket may opt for gabapentin over Lyrica due to its cost-effectiveness.
  • Doctors treating individuals with alcohol withdrawal syndrome cannot prescribe Lyrica as it is not an off-label use.
  • Patients who need a quick-acting medication may be prescribed Lyrica since it is absorbed faster and works more quickly.

Individuals who require a gabapentinoid medication may be prescribed either. However, in cases where the patient cannot tolerate the side effects of one, their physician may consider switching them to the other.

Are Either of These Drugs Habit-Forming?

Yes, Lyrica is listed as a Schedule V Controlled Substance, which means it is federally controlled. Medications in this class have the potential for abuse and misuse, which can lead to dependency. When taken as prescribed, there’s a relatively low risk of Lyrica dependency. However, taking it in abusive doses or in a manner other than prescribed greatly increases the likelihood of developing a tolerance.[12]

When someone develops a tolerance, they will need more of the medication to experience the original effects. Since Lyrica is a potent drug, taking too much can lead to dependence and even overdose.[13]

What Happens if You Take Both Together?

According to an abstract published by PubMed, gabapentin and pregabalin are both approved for adjunctive therapy and pain control.[14] However, in some instances, they are used together as a combination therapy to treat severe neuropathic pain. In this instance, researchers found that using it together produced a synergistic effect and pain control without a clinically significant interaction.

This form of combination therapy is a first-line treatment for individuals experiencing refractory pain and those with low levels of tolerance for an individual agent.[14]

Disclaimer: These two medications should not be combined without the consent of a physician. Combining them without guidance will increase their side effects and the risk of a possible overdose.

Can Lyrica and Gabapentin be Used Interchangeably?

Yes, sometimes a doctor may prefer their patient to start with one medication before switching to the other. This approach is common in the initial treatment stages to assess how the patient tolerates the drug. It can also be a cost-effective strategy, as insurance plans might cover one medication but not the other.

Getting Help for Lyrica or Gabapentin Addiction

Some individuals mix gabapentin or Lyrica with opioids to induce a euphoric high. However, doing this has been shown to increase the risk of respiratory depression and the unfortunate occurrence of opioid related deaths.[15] Mixing gabapentin with an opioid can lead to a fourfold higher risk of respiratory depression and overdose-related death than taking it on its own.[15]

Although one percent of the population is estimated to abuse gabapentin, 15 to 20% of people who abuse opioids were found to have gabapentin in their system.[15]

Signs of gabapentin and Lyrica addiction include:[15]

  • Needing more of the medication to reach the desired effect.
  • Experiencing withdrawal when trying to quit.
  • Having cravings to use the medication.
  • Seeking out multiple doctors to obtain a gabapentin or Lyrica refill.
  • Attempting to quit using gabapentin or Lyrica without success.
  • Spending a lot of time trying to find more gabapentin or Lyrica
  • Avoiding activities to recover from the effects of using Lyrica or gabapentin.

Both gabapentinoids are dangerous to withdraw from without a taper dose. Doing so can lead to a seizure. Before stopping your prescription, speak to your physician.

Next, reach out to a drug and alcohol rehab, such as Southeast Addiction Center GA, to help you overcome your struggle with addiction. We provide a supportive environment away from triggers and temptations that may cause you to use. We also offer a structured schedule to help you establish habits that can reduce the risk of relapsing.

Our programs feature behavioral therapy and peer support to boost overall well-being and help you develop healthier coping skills that lower the risk of relapse.

To learn more about our comprehensive approach to care, give us a call at (615) 326-6449.