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Neurontin or Lyrica? What’s the Difference?

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By Rosanna Sutherby, PharmD

Neurontin and Lyrica are medications used to treat seizures, nerve pain, and other conditions. You may wonder how they are different and why a doctor would prescribe one over the other. Although these medications are similar in some ways, a few differences distinguish them.

What Are Neurontin and Lyrica?

Neurontin is the brand name for gabapentin, which is an anticonvulsant (antiseizure medication) used to treat seizures and other conditions. Lyrica is the brand name for pregabalin, and it is similar to Neurontin in structure. Pregabalin is an anticonvulsant and analgesic (pain medication) used to treat neuropathic (nerve-related) pain and other conditions.

What Conditions Do Neurontin and Lyrica Treat?

Neurontin is approved by the Food and Drug Administration (FDA) to treat the following conditions:

Neurontin is also used off-label (not FDA-approved) to treat the following conditions:

  • nerve pain related to conditions other than shingles
  • fibromyalgia
  • bipolar disorder
  • hot flashes related to menopause
  • essential tremors (involuntary shaking that is not associated with Parkinson’s disease)
  • anxiety and other mood issues
  • irritable bowel syndrome
  • alcohol withdrawal
  • pain relief after surgery
  • prevention of migraine headaches
  • nausea and vomiting
  • bladder problems
  • social phobia
  • itching
  • insomnia (difficulty sleeping)
  • post-traumatic stress disorder
  • chronic cough not controlled by other methods

Lyrica is approved by the FDA to treat the following conditions:

  • nerve pain related to diabetes
  • nerve pain related to spinal cord injury
  • nerve pain related to shingles
  • fibromyalgia
  • seizures

Additionally, Lyrica is used off-label to treat the following conditions:

  • anxiety
  • social anxiety disorder
  • bipolar disorder
  • insomnia
  • chronic pain

What Are the Side Effects of Neurontin and Lyrica?

Although Neurontin and Lyrica have similar chemical structures, some side effects are different. The most common side effects of Neurontin include the following:

  • dizziness
  • loss of muscle control and coordination
  • headache
  • back pain
  • blurred vision
  • double vision
  • weakness
  • trembling
  • cold or flu-like symptoms
  • swelling in the hands, lower legs, or feet
  • weight gain

Lyrica has relatively fewer side effects than Neurontin. The most common side effects of Lyrica include the following:

  • drowsiness
  • dizziness
  • blurred vision
  • trouble concentrating
  • dry mouth
  • abnormal thoughts
  • swelling in the hands, lower legs, or feet
  • weight gain

This list does not represent all possible side effects for Neurontin and Lyrica. Be sure to discuss any concerns you have about your medication with your pharmacist.

What Medications Interact with Neurontin and Lyrica?

Several medications can interact with both Neurontin and Lyrica. Be sure to discuss all your medicines with your doctor or pharmacist for possible drug interactions.

The following drugs can have additive drowsiness and dizziness side effects with Neurontin and Lyrica:

  • alcohol
  • some antihistamines, including cetirizine (Zyrtec), diphenhydramine (Benadryl), and chlorpheniramine (Chlor-Trimeton)
  • some medications that treat anxiety, including alprazolam (Xanax) and hydroxyzine (Atarax, Vistaril)
  • drugs used for sleep, including eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien)
  • some antidepressants, including amitriptyline (Elavil), mirtazapine (Remeron), and trazodone (Desyrel)
  • muscle relaxers, including carisoprodol (Soma) and cyclobenzaprine (Flexeril)
  • some pain medication, including oxycodone, hydrocodone, and tramadol (Ultram)

If you are using Neurontin or Lyrica to treat seizures, the following medicines can increase the likelihood of a seizure occurring:

  • medications that treat certain mental disorders (e.g., schizophrenia), including chlorpromazine (Thorazine), prochlorperazine (Compazine), and thioridazine (Mellaril)
  • amphetamine drugs that treat attention deficit and hyperactivity disorder (ADHD), including amphetamine salts (Adderall)

Neurontin and Lyrica have similar drug interactions with a few exceptions:

  • Antacids: Antacids decrease the availability of Neurontin in your body. You should wait two hours after taking an antacid before taking Neurontin.
  • Angiotensin-converting enzyme (ACE) inhibitors: Taking certain blood pressure medications known as ACE inhibitors (e.g., lisinopril, enalapril) with Lyrica has caused life-threatening swelling of the face, mouth, and throat.
  • Diabetic medication: Some medications used to treat diabetes, including pioglitazone (Actos) and rosiglitazone (Avandia), can cause weight gain, swelling, and fluid retention if taken with Lyrica.

The list above does not include all possible drug interactions with Neurontin or Lyrica. Your pharmacist can help you decide if Neurontin and Lyrica are safe to take with your other medications.

Which Works Better? Neurontin or Lyrica?

When choosing between Neurontin and Lyrica, you must consider several factors, including side effects and interactions with medicines you already take. The answer to the question of which works better depends on what condition you are treating. Both Neurontin and Lyrica have several indications as well as off-label uses. Neurontin is used more frequently for seizures and mood disorders, but both drugs are used to treat nerve pain. Lyrica, however, is approved by the FDA to treat fibromyalgia, and it is prescribed more often than Neurontin for this condition.

review of studies shows that Lyrica (pregabalin) is more effective in treating fibromyalgia than Neurontin (gabapentin). On the other hand, a 2019 clinical trial shows that gabapentin works better than pregabalin at treating chronic sciatica (nerve pain that radiates from the lower back down the back of one leg).

A discussion with your healthcare provider will help you determine which medication is right for you.

How Much Do Neurontin and Lyrica Cost?

The cost of Neurontin and Lyrica varies based on your insurance coverage, where you live, and where you shop. Generally, Neurontin costs less than Lyrica. At the time of this article, the average retail prescription cost for thirty gabapentin 300 mg capsules is about $27. The average retail prescription cost for thirty 75 mg pregabalin capsules is about $203.

Remember to consider several factors when deciding which medication is right for you. Your healthcare provider will prescribe medicine that is appropriate for your symptoms and condition. If your insurance does not cover your medication, you can use a prescription discount card to get the lowest prescription price at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.wellrx.com/gabapentin/monographs/

https://www.wellrx.com/hn/us/assets/health-condition/epilepsy/~default/

https://www.wellrx.com/hn/us/assets/health-condition/fibromyalgia/~default/

https://www.wellrx.com/pregabalin/monographs/

https://www.wellrx.com/hn/us/assets/health-condition/shingles-and-postherpetic-neuralgia/~default/

https://www.ncbi.nlm.nih.gov/books/NBK78947/

https://jamanetwork.com/journals/jamaneurology/fullarticle/2707478

https://www.wellrx.com/prescriptions/gabapentin/houston,%20tx%2077023,%20usa

https://www.wellrx.com/prescriptions/pregabalin/houston,%20tx%2077023,%20usahttps://www.wellrx.com/family-prescription-savings

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