One might perceive gabapentin (Neurontin) as modestly favorable over pregabalin (Lyrica) on the basis of its: (1) lower abuse potential; (2) shorter duration of action; (3) availability as a standard prescription; (4) greater number of formatting options; (5) lower cost. In comparison, users of pregabalin will be under its influence and prone to treatment-related side effects for a bulk of the day (8 to 14 hours) – which may be less preferable. Findings This randomized clinical trial of pregabalin vs gabapentin in 18 patients with chronic sciatica found that gabapentin was superior to pregabalin with greater reduction of … Gabapentin VS Pregabalin. Hello everyone, Hope everyone is having a lovely weekend (It is my 21st birthday today, I am wild!!) As of current, it is unclear as to whether specific withdrawal symptoms and/or withdrawal symptom severities differ significantly between users of pregabalin and users of gabapentin. If attempting to determine whether pregabalin (Lyrica) or gabapentin (Neurontin) is “better” (on average) relative to the other, it’s necessary to reflect upon variables that prospective users and/or medical professionals deem important, including: average cost; effectiveness in the treatment of medical conditions; formatting and dosing; onset and duration of action; official (FDA-approved) medical uses; side effects and tolerability; and withdrawal severity. Considering the higher occurrence rates of euphoria among pregabalin users (relative to gabapentin users) and the stronger action of pregabalin on α2δ subunit-containing VDCCs (relative to gabapentin users), one would expect pregabalin (Lyrica) to exhibit greater abuse/addiction potential than gabapentin (Neurontin) when administered at therapeutic doses. All of these drugs are prescribed as anticonvulsant or antiepileptic medications. Oral gabapentin (Neurontin) solution is available in size-customizable bottles and offers one dosage increment of 250 mg/5 mL. ): Another reason some patients and/or medical doctors might prefer using gabapentin over pregabalin is related to its lower abuse/addiction potential. Additionally, patients receiving pregabalin or gabapentin aren’t routinely “drug tested” to detect whether these agents are being administered as is medically directed – and gabapentin can be easily refilled without an appointment (due to its availability as a standard prescription in the U.S.). For the study, 152 patients with a history of DPNP-related pain (minimum 40-mm score on visual analogue scale (VAS)) were assigned at random to receive gabapentin, pregabalin, or duloxetine for a 12-week duration. Lyrica (pregabalin) and gabapentin are similar medications in terms of their uses, efficacy and side effect profile. I have opted for pregabalin as I hear that gabapentin can make you gain weight and Im getting married in September I cant afford to put weight on! Based on systematic reviews and side effect data, gabapentinoids (pregabalin and gabapentin) are suggested to exhibit limited or negligible abuse and addiction potential. Price of Pregabalin Vs. Gabapentin. Various limitations associated with these studies included: (1) unequal potency (of dose) comparisons; (2) inflexible dosing; (3) indirect comparisons; (4) data extraction (from studies with parameter disparities); (5) inclusion of questionnaire data; (6) research and authorship by Pfizer Inc. employees; (7) potential reporting bias, sponsorship bias; and/or publication bias. Although pregabalin and gabapentin share common secondary neurochemical actions, it remains unclear as to whether there’s a difference in respective magnitudes of their secondary neurochemical effects. There are also subtle differences in the incidence rates of side effects associated with pregabalin (Lyrica) and gabapentin (Neurontin). For example, persons who use gabapentinoids “as needed” for intermittent and/or short-term management of medical symptoms might only require symptom management for 4 to 6 hours – making gabapentin a potentially-superior choice over pregabalin. For example, according to Manville and Abbott (2018), gabapentin is a potent activator of the voltage-gated potassium channels (VGPCs) KCNQ2/3; KCNQ3; and KCNQ5 – whereas pregabalin does not activate (at standard doses) or inhibits (at high doses) KCNQ2/3. Nystagmus (acquired pendular or infantile). Insomnia. Because studies suggest that pregabalin might be more effective than gabapentin (but none suggest the opposite), the potentially-superior efficacy of pregabalin makes it favorable over the gabapentin. In 2017, the United Kingdom opted to modify the legal classification of pregabalin and gabapentin from standard prescriptions to “Class C” controlled substances. Based on studies of gabapentin and pregabalin in epilepsy, the EC50 values of pregabalin and gabapentin were estimated to be about 9.77 mg/mL and 23.9 mg/mL, respectively. Since the bioavailability of gabapentin precipitously decreases at high doses (due to saturation of its transport mechanism), persons who intentionally abuse/misuse gabapentin (such as by ingesting a supratherapeutic dose) may experience a “ceiling-like effect” whereby its neurochemical effect basically plateaus at a high dose. Although sensitivity analyses substantiated the findings of the base-case analysis, the sensitivity analyses did not find statistical significance between pregabalin and gabapentin. Reasons the popularity of pregabalin might increase in future years include: (1) its higher potency (relative to gabapentin); (2) its longer duration of action (relative to gabapentin); (3) its availability in a greater number of dosing increments (than gabapentin); (4) its FDA-approval to treat more conditions (than gabapentin); and (5) its potentially-superior efficacy in the treatment of medical conditions (relative to that of gabapentin). find it more tolerable and effective) relative to the other. There are numerous reasons as to why gabapentin is currently, and has historically, been more popular than pregabalin, including: (1) its release ~11 years prior to that of pregabalin; (2) its status as the only “gabapentinoid” medication available (for ~11 years prior to gabapentin); (3) its ability to treat the same medical conditions as pregabalin; (4) its availability as a generic prior to pregabalin; and (5) its classification as a “standard prescription” medication (rather than a Schedule V substance like pregabalin). Included below are summaries of studies in which the efficacies of pregabalin and gabapentin are discussed and/or compared for neuropathic pain and fibromyalgia. with a pill cutter) by persons who wish to modify or titrate dosing. Differences Between Lyrica (Pregabalin) and Gabapentin In the U.S., medicines containing gabapentin are approved to treat seizures, post-herpetic neuralgia, and restless legs syndrome. This study provided Class II evidence to suggest that pregabalin and gabapentin do not differ in efficacy as adjuncts for the treatment of partial onset seizures. conducted a meta-analysis indirectly comparing the efficacies of gabapentin (GPB); pregabalin (PGB); duloxetine (DLX); and amitriptyline (AMT) – in the treatment of diabetic peripheral neuropathic pain (DPNP). In other words, twice-per-day dosing with pregabalin is probably more convenient for most than thrice-per-day dosing with gabapentin. Lyrica vs. gabapentin. According to side effect data compiled by the FDA, pregabalin is more likely (than gabapentin) to cause: blurred vision, weight gain, difficulty concentrating, dry mouth, and increased appetite – and gabapentin is more likely (than pregabalin) to cause: ataxia, fatigue, nystagmus, fever, nausea, vomiting, and hostility. Because the body is unable to use a noteworthy percentage of ingested gabapentin (especially at high doses), the circulating excess (unused portion) might increase risk of toxicity and/or provoke adverse reactions. Although standard pregabalin (Lyrica) and standard gabapentin (Neurontin) are both available in capsule and oral solution formats, gabapentin is also sold in an additional tablet format. Although pregabalin (Lyrica) might “kick in” slightly slower than gabapentin (Neurontin), the duration of action for standard pregabalin is longer (8 to 14 hours) than the duration of action for standard gabapentin (5 to 8 hours). The superior efficacy of pregabalin over gabapentin was evidenced by: (1) a greater reduction in the number of days with moderate-to-severe pain; and (2) greater quality of life – over a 12-week period – among pregabalin users relative to gabapentin users. It’s also possible that the diminishing bioavailability of gabapentin at high doses decreases toxicity among misusers. It is a common misconception that gabapentin is the generic of Lyrica. Pharmacodynamics of pregabalin and gabapentin Gabapentin and pregabalin vary in terms of binding affinity and potency. 4. Both drugs are classified as gabapentinoids—a class of substances with similar mechanisms of action and many common side effects. The researchers did state that pregabalin (Lyrica) appears slightly more addictive than gabapentin (Neurontin) in aspects such as: magnitude of behavioral dependence symptoms; transitions from prescription to self-administration; and durability of self-administration. Moreover, while pregabalin (Lyrica) and gabapentin (Neurontin) have extremely similar mechanisms of action, some studies suggest that the former (pregabalin) exhibits approximately 6-fold greater affinity for α2δ subunit-containing voltage-dependent calcium channels (VDCCs) – than the latter (gabapentin). Anxiety disorders. Note: If you know of additional differences between pregabalin (Lyrica) and gabapentin (Neurontin) that weren’t mentioned in the above summary, feel free to share them in the comments. Gabapentin (Neurontin 1) and pregabalin (Lyrica 2) are first- and second-generation α2δ ligands, respectively, and are both approved for use as adjunctive therapy in pain control. If you have experience with the gabapentinoid medications – pregabalin (Lyrica) and gabapentin (Neurontin), leave a comment regarding whether you: (A) prefer one medication over the other OR (B) have no substantial preference for using one medication over the other. Why? It is extremely common for former pregabalin (Lyrica) and gabapentin (Neurontin) to report withdrawal symptoms that persist for weeks after the date of treatment cessation. Although the research evidence is sparse, pregabalin and gabapentin have both been shown to be effective at improving the physical and psychological symptoms of GAD. Neurontin (gabapentin) was first approved by the U.S. FDA in 1993 for the treatment of epilepsy; subsequently in 2002 for the treatment of postherpetic neuralgia; and again in 2011 (in a prodrug format) for the treatment of restless leg syndrome (RLS). (2010), the oral bioavailability of pregabalin is ~90% regardless of its dosage, whereas the oral bioavailability of gabapentin ranges from ~27% to ~60% and is inversely proportionate to its dosage (smaller doses exhibit higher bioavailability than larger doses). The oral bioavailability of pregabalin is ~90% – whereas the oral bioavailability of gabapentin ranges from ~27% to ~60%. Furthermore, while there may be differences in common side effects (occurring in at least 5% of users) for pregabalin (Lyrica) and gabapentin (Neurontin), adverse effects reported for both medications include: appetite changes; blurred vision; cognitive impairment; constipation; depression; dry mouth; fever; headache; incoordination; nausea; nystagmus; weight gain; sexual dysfunction; suicidality; and vomiting. conducted a study to assess the cost-effectiveness of pregabalin relative to gabapentin in the treatment of postherpetic neuralgia and peripheral neuropathic pain. Anxiety disorders. In comparison, Schedule V substances like pregabalin can only be refilled a maximum of 5 times within 6 months before additional doctor appointments are needed for further refills. If we assume that there are no differences between pregabalin and gabapentin in cost (prescriptions plus annual doctor appointments expenses required to attain prescriptions) and that there might be differences in pregabalin and/or gabapentin in efficacy and/or tolerability – then it makes sense to favor the use of pregabalin. Ataxia. In standard format, pregabalin (Lyrica) exhibits an average duration of action from 8 to 14 hours – whereas gabapentin (Neurontin) exhibits an average duration of action from 5 to 8 hours. Note: Both pregabalin and gabapentin are regularly prescribed off-label for conditions like alcohol use disorder, alcohol withdrawal, anxiety disorders, insomnia, pruritus, restless leg syndrome (RLS), and tremor. 2013: Pregabalin versus gabapentin in the management of peripheral neuropathic pain associated with post-herpetic neuralgia and diabetic neuropathy: a cost effectiveness analysis for the Greek healthcare setting. JAMA Neurol. This suggests that there could be neurochemical actions unique to pregabalin that increase its abuse/addiction potential and/or neurochemical actions unique to gabapentin that decrease its abuse/addiction potential (relative to pregabalin). Nonetheless, it’s possible that some individuals will respond significantly better to pregabalin (relative to gabapentin) – and others will respond significantly better to gabapentin (relative to pregabalin). Weight gain. Moreover, while pregabalin and gabapentin share many common secondary neurochemical actions, research has unveiled subtle pharmacodynamic disparities between these agents. You, as a reader of this website, are totally and completely responsible for your own health and healthcare. For this reason, it remains unknown as to whether pregabalin and gabapentin differ in therapeutic efficacy for the treatment of fibromyalgia. Neurontin is a prescription medicine used to treat:. Hence, looking only at the per unit value of both drugs, it comes cheaper with the average price at $13.38 for 90 capsules or $0.1497 each. (2010) suggested that pregabalin might be more effective than gabapentin in the treatment of partial onset seizures, however, sensitivity analyses revealed no statistically-significant differences in the efficacies of pregabalin and gabapentin. Everything considered, standard Lyrica capsules are cheaper than standard Neurontin capsules/tablets at moderate-to-high doses (e.g. Formatting options: Although gabapentin is available in fewer total dosing increments than pregabalin, gabapentin offers a greater number of formatting options than pregabalin. Pain from damaged nerves (postherpetic pain) that follows healing of shingles (a painful rash that comes after a herpes zoster infection) in adults. Nevertheless, some individuals might have developed preferences for one medication relative to the other. 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