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Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
Lyrica and gabapentin are prescription drugs used to treat nerve pain and partial-onset seizures. Lyrica is a brand-name drug containing pregabalin while gabapentin is a generic drug known by the brand names Neurontin, Gralise, and Horizant.
Lyrica and gabapentin are part of a group of drugs called anticonvulsants, or antiepileptic drugs. However, they also have analgesic, or pain-relieving, properties. These drugs are believed to provide therapeutic benefits through their effects on the central nervous system (CNS). They help decrease the release of certain neurotransmitters and slow down nerve signals involved with pain and seizures.
Although they’re similar drugs with identical uses, Lyrica and gabapentin differ in several ways. Continue reading to learn more about the similarities and differences between these drugs.
What are the main differences between Lyrica vs. gabapentin
They contain different active ingredients
Both drugs are available as brand-name or generic drugs. Pregabalin is the active ingredient in Lyrica while gabapentin is the active ingredient in Neurontin, Gralise, and Horizant.
Lyrica is absorbed better than gabapentin
Pregabalin also has a higher bioavailability than gabapentin. Bioavailability refers to how much of the drug is absorbed into the body unchanged. Pregabalin has a bioavailability of 90% while gabapentin has a bioavailability of 60%. The bioavailability of gabapentin decreases with higher doses.
Pregabalin is also absorbed faster than gabapentin. Pregabalin reaches maximum levels in the blood within 1.5 hours while gabapentin reaches maximum levels in the blood within two to four hours.
Lyrica and gabapentin are available in different formulations
Lyrica is available as a 20 mg/mL oral solution and a 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, or 300 mg oral capsule. Lyrica is also available as an extended-release tablet called Lyrica CR that comes in strengths of 82.5 mg, 165 mg, and 330 mg.
Gabapentin is available as a 100 mg, 300 mg, or 400 mg oral capsule; a 300 mg, 600 mg, or 800 mg oral tablet; and a 250 mg/5 mL oral solution. Horizant contains gabapentin enacarbil in a 300 mg or 600 mg extended-release tablet.
Refer to the table below for other differences.
| Main differences between Lyrica and gabapentin | ||
|---|---|---|
| Lyrica | Gabapentin | |
| Drug class | Anticonvulsant | Anticonvulsant |
| Brand/generic status | Brand and generic version available | Brand and generic version available |
| What is the generic/brand name? | Brand name: Lyrica Generic name: Pregabalin |
Brand name: Neurontin Generic name: Gabapentin |
| What form(s) does the drug come in? | Capsule Tablet, extended-release Oral solution |
Capsule Tablet Tablet, extended-release Oral solution |
| What is the standard dosage? | 50 to 100 mg three times daily | 300 to 600 mg three times daily |
| How long is the typical treatment? | Long term | Long term |
| Who typically uses the medication? | Adults and children aged 1 month and older | Adults and children aged 3 years and older |
Conditions treated by Lyrica and gabapentin
Lyrica and gabapentin are prescription medications approved by the Food and Drug Administration (FDA) to treat seizures associated with epilepsy. More specifically, Lyrica and gabapentin are used with other medications (as adjunctive therapy) for partial-onset seizures. Both Lyrica and gabapentin are also FDA-approved to treat postherpetic neuralgia, or nerve pain caused by shingles.
In addition to partial-onset seizures and postherpetic neuralgia, Lyrica is also approved to treat fibromyalgia and nerve pain associated with diabetic peripheral neuropathy or spinal cord injury. Gabapentin is sometimes used off-label for these indications.
Gabapentin enacarbil, which is currently only available as Horizant, is approved to treat restless leg syndrome and postherpetic neuralgia.
Other off-label uses of Lyrica and gabapentin include the treatment of bipolar disorder, anxiety, and insomnia.
| Condition | Lyrica | Gabapentin |
| Neuropathic pain associated with diabetic peripheral neuropathy (DPN) | Yes | Off-label |
| Postherpetic neuralgia (PHN) | Yes | Yes |
| Fibromyalgia | Yes | Off-label |
| Neuropathic pain associated with spinal cord injury | Yes | Off-label |
| Adjunctive therapy for partial-onset seizures | Yes | Yes |
| Restless leg syndrome | Off-label | Yes |
| Bipolar disorder | Off-label | Off-label |
| Anxiety | Off-label | Off-label |
| Insomnia | Off-label | Off-label |
Is Lyrica or gabapentin more effective?
Both Lyrica and gabapentin are effective options for nerve pain relief. The best option for you will depend on your overall condition, the cost of the drug, and other factors.
Few head-to-head trials compare the effectiveness of Lyrica and gabapentin for their approved uses. One systematic review and meta-analysis found no significant difference between pregabalin and gabapentin for treating nerve pain. The meta-analysis pooled several clinical trials together and showed identical safety profiles and tolerability for both drugs.
Another meta-analysis compared the effectiveness of gabapentin and pregabalin to duloxetine, an SNRI drug, for nerve pain from DPN. Results found that all three drugs were more effective than a placebo, although they caused some side effects like dizziness or drowsiness.
Seek medical advice from a healthcare provider before starting treatment with Lyrica or gabapentin. A prescribing doctor will assess your overall condition to determine the best treatment option for you, especially if you are experiencing chronic pain.
Coverage and cost comparison of Lyrica vs. gabapentin
Lyrica is a brand-name drug that can be expensive with or without insurance. Most Medicare and insurance plans will help cover the cost of the generic version of Lyrica. Without insurance, the average retail price of Lyrica is $314. Savings options like a savings card from SingleCare may help reduce the cash price of the drug.
Gabapentin is a generic drug that is covered by most, if not all, insurance plans. Compared to Lyrica, gabapentin generally costs less. Without insurance, the average retail price of gabapentin is $155. A SingleCare card for gabapentin could help reduce the cash price.
| Lyrica | Gabapentin | |
| Typically covered by insurance? | Yes, the generic version is usually covered | Yes |
| Typically covered by Medicare Part D? | Yes, the generic version is usually covered | Yes |
| Quantity | 30, 75 mg capsules | 90, 300 mg capsules |
| Typical Medicare copay | $19–$543 | $0–$30 |
| SingleCare cost | $9+ | $8+ |
Common side effects of Lyrica vs. gabapentin
The most common side effects of Lyrica include drowsiness, dizziness, dry mouth, edema, gas (flatulence), and weight gain. The most common side effects of gabapentin include dizziness, drowsiness, diarrhea, weakness, and edema. Both medications can also cause an increased risk of infections and eye problems, like blurred or reduced vision.
See the table below for a list of possible side effects.
| Lyrica | Gabapentin | |||
| Side Effect | Applicable? | Frequency | Applicable? | Frequency |
| Dizziness | Yes | 8% | Yes | 28% |
| Drowsiness | Yes | 4% | Yes | 21% |
| Dry mouth | Yes | 3% | Yes | 5% |
| Edema | Yes | 4% | Yes | 8% |
| Diarrhea | Yes | * | Yes | 6% |
| Constipation | Yes | 4% | Yes | 4% |
| Nausea | Yes | * | Yes | 4% |
| Infection | Yes | 14% | Yes | 5% |
| Blurred or reduced vision | Yes | 3% | Yes | 3% |
| Weakness | Yes | 4% | Yes | 6% |
| Flatulence | Yes | 3% | No | – |
| Shortness of breath | Yes | 3% | Yes | * |
Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.
*not reported
Source: DailyMed (Lyrica), DailyMed (Gabapentin)
Drug interactions of Lyrica vs. gabapentin
Lyrica and gabapentin are primarily cleared from the body through the kidneys. They both carry a lower risk of drug interactions than other drugs that are heavily processed in the liver.
Because of how they work, Lyrica and gabapentin can cause CNS side effects like drowsiness and dizziness. Taking Lyrica or gabapentin with another drug that has CNS depressant effects can increase the risk of drowsiness, dizziness, and sedation. Drugs that have CNS effects include opioids, benzodiazepines, monoamine oxidase inhibitors, muscle relaxants, and antipsychotic medications.
Antacids like Maalox that contain aluminum hydroxide and magnesium hydroxide can decrease the bioavailability of gabapentin. It is recommended to wait at least two hours after taking Maalox before taking a dose of gabapentin.
| Drug | Drug Class | Lyrica | Gabapentin |
| Oxycodone Hydrocodone Morphine |
Opioids | Yes | Yes |
| Lorazepam Diazepam Clonazepam Alprazolam |
Benzodiazepines | Yes | Yes |
| Selegiline Phenelzine Rasagiline |
Monoamine oxidase inhibitor (MAOI) | Yes | Yes |
| Metaxalone Methocarbamol Baclofen |
Muscle relaxant | Yes | Yes |
| Pimozide | Antipsychotic | Yes | Yes |
| Aluminum hydroxide Magnesium hydroxide |
Antacid | No | Yes |
This may not be a complete list of all possible drug interactions. Consult a doctor about all the medications you may be taking.
Warnings of Lyrica and gabapentin
It is possible to experience severe sedation and respiratory depression after taking Lyrica or gabapentin. The risk of these adverse events is increased when combining Lyrica or gabapentin with opioids, benzodiazepines, or other CNS depressants. Severe drowsiness and dizziness may impair a person’s ability to drive and operate machinery.
The abrupt discontinuation of Lyrica or gabapentin may increase the risk of seizures. These medications should only be stopped with help from a healthcare provider.
The use of Lyrica or gabapentin may increase the risk of suicidal thoughts and behaviors. People with a history of depression should be monitored while taking Lyrica or gabapentin.
Allergic reactions are possible while taking Lyrica or gabapentin. Seek immediate medical attention if signs or symptoms of an allergic reaction develop, such as hives, trouble breathing, or swelling of the face and throat.
Lyrica is a Schedule V controlled substance that carries a risk of misuse or abuse. Gabapentin is not considered a controlled substance.
Frequently asked questions about Lyrica vs. gabapentin
What is Lyrica?
Lyrica is a brand-name prescription drug used to treat pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, fibromyalgia, and spinal cord injury. It is also approved as an adjunctive therapy for partial seizures. The generic name of Lyrica is pregabalin. An extended-release version of Lyrica is available called Lyrica CR.
What is gabapentin?
Gabapentin is a generic prescription drug used to treat partial seizures and nerve pain associated with postherpetic neuralgia. The brand names of gabapentin include Neurontin, Gralise, and Horizant. Horizant is an extended-release tablet that contains gabapentin enacarbil and is approved to treat restless leg syndrome and postherpetic neuralgia.
Are Lyrica and gabapentin the same?
Lyrica and gabapentin are anticonvulsants that may be prescribed as first-line treatments for nerve pain. Also referred to as gabapentinoids, Lyrica and gabapentin are structurally similar to the GABA (gamma-aminobutyric acid) neurotransmitter. However, they do not act on the GABA receptors. Lyrica and gabapentin work in similar ways to slow down nerve signals, but they contain different active ingredients.
Is Lyrica or gabapentin better?
Lyrica and gabapentin are antiepileptic medications that have a similar mechanism of action. However, Lyrica is absorbed more completely and more quickly into the body than gabapentin. Lyrica may be a more potent option for pain relief. Still, both drugs are effective treatment options. The best option will depend on factors like the condition being treated, whether you have tried one treatment option already, and the cost of the drug.
Can I use Lyrica or gabapentin while pregnant?
Based on animal data, Lyrica and gabapentin may cause fetal harm. Therefore, it is not generally recommended to take Lyrica or gabapentin while pregnant.
Can I use Lyrica or gabapentin with alcohol?
It is not recommended to drink alcohol while taking Lyrica or gabapentin. Drinking alcohol with Lyrica or mixing alcohol with gabapentin may lead to increased side effects of drowsiness and dizziness.
Can you switch from gabapentin to pregabalin?
Gabapentin may be switched to pregabalin and vice versa. A healthcare provider may need to adjust the dosage when switching to either drug. Lyrica is absorbed faster than gabapentin. If you are switching from gabapentin to Lyrica, you will be prescribed a lower dosage of Lyrica. Consult with a healthcare provider to determine whether switching medications is right for you.
What is gabapentin mostly prescribed for?
Gabapentin is a generic drug that is mostly prescribed for pain associated with postherpetic neuralgia, or pain caused by shingles. It can also be prescribed with other medications to manage partial-onset seizures. Horizant, which contains gabapentin enacarbil, can be prescribed to treat restless leg syndrome.
Can I take gabapentin as needed for nerve pain?
Gabapentin has a short duration of action. It is generally prescribed to be taken three times per day for pain relief. Your healthcare provider may adjust the dosage based on your response to the drug. If you are not experiencing sufficient pain relief, your provider may increase the dosage of gabapentin.
What drugs should not be taken with gabapentin?
The use of gabapentin should be avoided or monitored while taking CNS depressants like opioids, benzodiazepines, and muscle relaxants. Taking these medications with gabapentin may increase the risk of drowsiness and dizziness. Antacids like Maalox (aluminum hydroxide and magnesium hydroxide) can decrease how well gabapentin is absorbed into the body. Wait at least two hours after taking Maalox before taking a dose of gabapentin.
