Pregabalin is a prescription medication that is approved by the FDA to treat nerve pain, fibromyalgia, and seizures. It is a well-tolerated medication, but like all medications, it carries the risk of drug interactions that can alter its efficacy or increase the chances of side effects.

Drug interactions refer to reactions that affect how a medication acts in an individual’s body, potentially altering its effectiveness or safety. There are three types of drug interactions.

Drug-drug interaction: A reaction between two or more drugs, including both over-the-counter and prescription drugs.

Drug-food interaction: A reaction occurs when eating a food item or drinking a beverage can affect how a medication works.

Drug-condition interaction: This occurs when a specific health condition affects the way a medication works.

Understanding how Pregabalin interacts with other drugs is important for your safety and treatment outcomes. In this blog, we have discussed some Pregabalin drug interactions that you should be aware of.

Pregabalin Drug Interactions

There are various prescription drugs that have the potential to interact with Pregabalin medicine, including opioids, muscle relaxants, benzodiazepines, antihistamines, sedatives, and certain blood pressure medications [1].

Muscle relaxants

Muscle relaxants are a group of medications that are used to relax or alleviate muscle spasms and stiffness, which can help reduce pain.

Taking Pregabalin with muscle relaxants can lead to excessive sleepiness, poor muscle control, confusion, drowsiness, and even respiratory depression.

Examples of commonly prescribed muscle relaxants include Soma, Metaxalone, Zanaflex, Orphenadrine, and Amrix.

Certain Blood Pressure Medications (ACE inhibitors)

ACE inhibitors are a type of blood pressure medication that can help manage high blood pressure, coronary artery disease, and heart failure.

One of the uncommon side effects associated with ACE inhibitors is angioedema. This condition is characterized by swelling in the deep layers of the skin and is often seen with hives. Consequently, Pregabalin intake can also cause angioedema.

When taking ACE inhibitors and Pregabalin together, there is an increased possibility of angioedema. It’s crucial to be aware of the signs and symptoms of angioedema, including swelling around the eyes, throat swelling, a hot or painful sensation, and breathing difficulties. If Angioedema persists and causes breathing difficulties, it is a medical emergency, so seeking immediate medical help is necessary.

Examples of common ACE inhibitors include Perindopril, Vasotec, Lotensin, and Captopril.

Opioids

Opioids are prescription-based medications that are used to manage moderate to severe body pain.

Severe and deadly drug interactions can occur if Pregabalin is taken with an opioid pain reliever. This drug interaction could cause excessive central nervous system depression, respiratory depression, coma, sedation, or low blood pressure.

Examples of common opioids are Codeine, Levorphanol, Methadone, Belbuca, Tramadol, Nucynta, and Oxycodone.

Benzodiazepines 

Benzodiazepines are prescription drugs used for a variety of conditions, including insomnia, agitation, anxiety disorders, and seizure disorders. Taking Pregabalin and benzodiazepines together has the potential to cause excessive depression of the CNS.

Possible symptoms of this drug interaction are impaired coordination, lightheadedness, weakness, drowsiness, and respiratory depression. It is advised that doctors use caution and monitor therapy if both of these medications are prescribed together.

Examples of common benzodiazepines are Estazolam, Ativan, Xanax,

Onfi, and Oxazepam.

Antihistamines 

Antihistamines are medications used to alleviate allergy symptoms. When antihistamines are taken with a CNS depressant like Pregabalin, there is a risk of added depressant effects like sleepiness, confusion, weakness, poor muscle control, and possibly respiratory depression.

Examples of common antihistamines include Unisom, Claritin, Diphenhydramine, Astepro, and Zyrtec.

Other Pregabalin Interactions | Explained

In addition to interaction with different medications, Pregabalin can also interact with other substances, which are discussed below [2].

Pregabalin and alcohol 

Alcohol is a CNS depressant that slows down the nervous system. Drinking alcoholic beverages such as cocktails or beer can cause unsteady movement, inability to react quickly, disturbed perceptions, slurred speech, and impaired motor control. Side effects of Pregabalin when combined with alcoholic beverages can be enhanced with even more nervous system depression that can result in excessive sedation, an increased chance of falls, and a greater risk of accidental injury.

Pregabalin and food 

No drinks or foods have been reported to interact with Pregabalin. If you are interested in learning more about consuming certain beverages and food items during treatment with Pregabalin, talk to your healthcare provider.

Pregabalin and vaccine

Pregabalin is not known to interact with vaccines. You can ask your doctor or pharmacist if you have any questions about receiving vaccines while you’re taking Pregabalin.

Pregabalin interaction with herbs 

Pregabalin can interact with the herb valerian root, which many people often use to relieve anxiety.

Both Pregabalin and valerian root can cause similar side effects, including dizziness and sleepiness.  Taking Pregabalin and valerian root together can increase your risk of these adverse effects.

To gain a deeper understanding of the Valerian herb, visit WebMD’s comprehensive guide on this topic.

Pregabalin and vitamins 

There have been no reports of Pregabalin interacting with vitamins. However, it’s still crucial to check with your healthcare provider before taking any vitamins during Pregabalin treatment.

Pregabalin and health-related interactions 

Certain medical conditions can increase the chances of interaction with Pregabalin. Before you take Pregabalin, be sure to talk with your healthcare provider about your medical history. Pregabalin may not be the right treatment option for you if you have certain health conditions.

Medical conditions that might interact with Pregabalin include:

Heart problems

Pregabalin can cause fluid retention and swelling in your feet, legs, and hands. If you already have any heart condition, such as congestive heart failure, fluid retention, or swelling, it can worsen your condition. Therefore, your doctor should decide whether Pregabalin is safe for you to take based on your heart health.

Kidney problems 

After you take a dose of Pregabalin, your kidneys help get the drug out. If you have kidney issues, such as chronic kidney disease, your body may not eliminate Pregabalin as effectively. This can cause the level of the medication to build up in your body, which may increase your risk of unwanted effects. If you have a kidney issue, your medical provider will likely prescribe you a lower dose of the medication.

Breathing problems

In rare scenarios, Pregabalin can cause respiratory depression as a side effect, which can be life-threatening. If you already have a breathing issue, you may have an increased risk

of this side effect if you take Pregabalin. Examples of breathing problems include asthma and chronic obstructive pulmonary disease.

Depression and other mental health ailments

Like other seizure medications, taking Pregabalin may increase the risk of suicidal thoughts or behaviors. If you have any mental health condition, such as depression, you may have a higher risk of adverse effects than usual.

How To Reduce The Risk Of Pregabalin Interactions?

There are various steps that one can take to reduce the risk of Pregabalin interactions [3].

It is essential to keep your doctor informed about all your medical conditions and any other medications or supplements you are currently using. It’s also important to be honest with providers about alcohol and other substance use. Ask your medical provider the following questions before taking Pregabalin, such as: Can I take it with the other medications I am taking? Or, what are the possible drug interactions?

Several online tools are available to help you check for potential drug interactions. One reliable option is the Drug Interactions Checker on Drugs.com, where you can easily enter your medications to check for possible interactions.

Look for the “warnings” section on the labels of your prescription or over-the-counter medicines. Often, known drug interactions are written on labels or printed material that accompany the medication.

Conclusion

Whenever a new medication is started, including Pregabalin, it is essential to consult a doctor or pharmacist to determine if it will interact with other medicines. That way, drug interactions can be avoided before they occur. Also, discuss any new side effects if you notice them after taking a new medication, because they may be related to drug interactions.

This blog does not include a complete list of all Pregabalin interactions. Therefore, it is crucial to communicate openly with your primary healthcare provider to ensure proper health management.