LYRICA 225 mg hard capsules


What is it and how is it used?

LYRICA belongs to a group of medicines used to treat epilepsy, neuropathic pain and Generalised Anxiety Disorder (GAD) in adults.

Peripheral and central neuropathic pain: LYRICA is used to treat long lasting pain caused by damage to the nerves. A variety of diseases can cause peripheral neuropathic pain, such as diabetes or shingles. Pain sensations may be described as hot, burning, throbbing, shooting, stabbing, sharp, cramping, aching, tingling, numbness, pins and needles. Peripheral and central neuropathic pain may also be associated with mood changes, sleep disturbance, fatigue (tiredness), and can have an impact on physical and social functioning and overall quality of life.

Epilepsy: LYRICA is used to treat a certain form of epilepsy (partial seizures with or without secondary generalisation) in adults. Your doctor will prescribe LYRICA for you to help treat your epilepsy when your current treatment is not controlling your condition. You should take LYRICA in addition to your current treatment. LYRICA is not intended to be used alone, but should always be used in combination with other anti-epileptic treatment.

Generalised Anxiety Disorder: LYRICA is used to treat Generalised Anxiety Disorder (GAD). The symptoms of GAD are prolonged excessive anxiety and worry that are difficult to control. GAD can also cause restlessness or feeling keyed up or on edge, being easily fatigued (tired), having difficulty concentrating or mind going blank, feeling irritable, having muscle tension or sleep disturbance. This is different to the stresses and strains of everyday life.

What do you have to consider before using it?

Do not take LYRICA
if you are allergic (hypersensitive) to pregabalin or any of the other ingredients of Lyrica.

Take special care with LYRICA

The safety and efficacy in children and adolescents (under 18 years of age) has not been established and therefore, pregabalin should not be used in this age group.

  • Some patients taking LYRICA have reported symptoms suggesting an allergic reaction. These symptoms include swelling of the face, lips, tongue, and throat, as well as diffuse skin rash. Should you experience any of these reactions, you should contact your physician immediately.
  • LYRICA has been associated with dizziness and somnolence, which could increase the occurrence of accidental injury (fall) in elderly patients. Therefore, you should be careful until you are used to any effect the medicine might have.
  • LYRICA may cause blurring or loss of vision, or other changes in eyesight, many of which are temporary. You should immediately tell your doctor if you experience any changes in your vision.
  • Some patients with diabetes who gain weight while taking pregabalin may need an alteration in their diabetic medicines.
  • Certain side effects may be more common, such as sleepiness, because patients with spinal cord injury may be taking other medicines to treat, for example, pain or spasticity, that have similar side effects to Pregabalin and the severity of these effects may be increased when taken together.
  • There have been reports of heart failure in some patients when taking Lyrica; these patients were mostly elderly with cardiovascular conditions. Before taking this medicine you should tell your doctor if you have a history of heart disease.
  • There have been reports of kidney failure in some patients when taking Lyrica. If while taking Lyrica you notice decreased urination, you should tell your doctor as stopping the medicine may improve this.
  • A small number of people being treated with anti-epileptics such as Lyrica have had thoughts of harming or killing themselves. If at any time you have these thoughts, immediately contact your doctor.
  • When LYRICA is taken with other medicines that may cause constipation (such as some types of pain medicines) it is possible that gastrointestinal problems may occur (e.g.,constipation, blocked or paralysed bowel). Tell your doctor if you experience constipation, especially if you are prone to this problem.
  • Before taking this medicine you should tell your doctor if you have a history of alcoholism or drug dependence. Let your doctor know if you think you need more medicine than prescribed.
  • There have been reports of convulsions when taking Lyrica or shortly after stopping Lyrica. If you experience a convulsion, contact your doctor immediately.
  • There have been reports of reduction in brain function (encephalopathy) in some patients taking Lyrica when they have other conditions. Tell your doctor if you have a history of any serious medical conditions, including liver or kidney disease.

Taking other medicines
Before taking any new medicine with LYRICA you should talk to your doctor. Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

LYRICA and certain other medicines may influence each other (interaction). When taken with certain other medicines, LYRICA may potentiate the side effects seen with these medicines, including respiratory failure and coma. The degree of dizziness, sleepiness and decreased concentration may be increased if LYRICA is taken together with medicinal products containing:

Oxycodone – (used as a pain-killer)
Lorazepam – (used for treating anxiety)

LYRICA may be taken with oral contraceptives.

Taking LYRICA with food and drink
LYRICA capsules may be taken with or without food.

It is advised not to drink alcohol while taking LYRICA

Pregnancy and breast-feeding
Ask your doctor or pharmacist for advice before taking any medicine.
LYRICA should not be taken during pregnancy, unless you are told otherwise by your doctor. Effective contraception must be used by women of child-bearing potential. Contact your doctor immediately if you become pregnant, think you might be pregnant or are planning to become pregnant while taking LYRICA.
It is not recommended to breast-feed your baby while using LYRICA as it is not known if LYRICA may be found in breast milk. Ask your doctor or pharmacist for advice before taking any medicine while breast-feeding.

Driving and using machines
LYRICA may produce dizziness, sleepiness and decreased concentration. You should not drive, operate complex machinery or engage in other potentially hazardous activities until you know whether this medicine affects your ability to perform these activities.

Important information about some of the ingredients of LYRICA:
Lyrica contains lactose monohydrate. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

How is it used?

Always take LYRICA exactly as your doctor has instructed you. You should check with your doctor or pharmacist if you are not sure.

Your doctor will determine what dose is appropriate for you.

LYRICA is for oral use only.

Peripheral and central neuropathic pain, epilepsy or Generalised Anxiety Disorder:

  • Take the number of capsules as instructed by your doctor.
  • The dose, which has been adjusted for you and your condition, will generally be between 150 mg and 600 mg each day.
  • Your doctor will tell you to take LYRICA either twice or three times a day. For twice a day take LYRICA once in the morning and once in the evening, at about the same time each day. For three

times a day take LYRICA once in the morning, once in the afternoon and once in the evening, at about the same time each day.

If you have the impression that the effect of LYRICA is too strong or too weak, talk to your doctor or pharmacist.

If you are an elderly patient (over 65 years of age), you should take LYRICA normally except if you have problems with your kidneys.

Your doctor may prescribe a different dosing schedule and/or dose if you have problems with your kidneys.

Swallow the capsule whole with water.

Continue taking LYRICA until your doctor tells you to stop.

If you take more LYRICA than you should
Call your doctor or go to the nearest hospital emergency unit immediately. Take your box or bottle of LYRICA capsules with you. You may feel sleepy, confused, agitated, or restless as a result of taking more LYRICA than you should.

If you forget to take LYRICA
It is important to take your LYRICA capsules regularly at the same time each day. If you forget to take a dose, take it as soon as you remember unless it is time for your next dose. In that case, just carry on with the next dose as normal. Do not take a double dose to make up for a forgotten dose.

If you stop taking LYRICA
Do not stop taking LYRICA unless your doctor tells you to. If your treatment is stopped it should be done gradually over a minimum of 1 week. If you have any further questions on the use of this product, ask your doctor or pharmacist.

After stopping long and short-term pregabalin treatment, you need to know that you may experience certain side effects. These include, trouble sleeping, headache, nausea, feeling anxious, diarrhoea, flu-like symptoms, convulsions, nervousness, depression, pain, sweating, and dizziness. It is not clear at this time whether these symptoms occur more commonly or severely if you have been taking pregabalin for a longer period of time.

What are possible side effects?

Like all medicines, LYRICA can have side effects, although not everyone gets them.

Very common side-effects which may affect more than 1 person in 10 are listed below:

Dizziness, tiredness

Common side-effects which may affect more than 1 person in 100 are listed below:

  • Increased appetite
  • Feeling of elation, confusion, disorientation, changes in sexual interest, irritability
  • Disturbance in attention, clumsiness, memory impairment, tremor, difficulty with speaking, tingling feeling, sedation, lethargy, insomnia, fatigue
  • Blurred vision, double vision
  • Vertigo, problems with balance
  • Dry mouth, constipation, vomiting, flatulence
  • Difficulties with erection
  • Swelling of the body including extremities
  • Feeling drunk, abnormal style of walking
  • Weight gain

Uncommon side-effects which may affect more than 1 person in 1000 are listed below:

  • Loss of appetite, low blood sugar
  • Change in perception of self, restlessness, depression, agitation, mood swings, difficulty finding words, loss of memory, hallucinations, abnormal dreams, panic attacks, apathy, feeling abnormal, problems with sexual functioning including inability to achieve a sexual climax, delayed ejaculation
  • Difficulty with thinking, numbness, changes in eyesight, unusual eye movement, jerky movements, reduced reflexes, increased activity, dizziness on standing, sensitive skin, loss of taste, burning sensation, tremor on movement, decreased consciousness, fainting, increased sensitivity to noise
  • Dry eyes, eye swelling, eye pain, weak eyes, watery eyes
  • Heart rhythm disturbances, increased heart rate, low blood pressure, high blood pressure
  • Flushing, hot flushes
  • Difficulty breathing, sore throat, dry nose
  • Swollen abdomen, increased saliva production, heartburn, numb around mouth
  • Sweating, rash ,chills
  • Muscle twitching, joint swelling, muscle cramp, muscle stiffness, pain including muscle pain, joint pain, back pain, pain in limb
  • Difficulty with or painful urination, incontinence
  • Weakness, fall, thirst, chest tightness
  • Changes in blood and liver test results (blood creatinine phosphokinase increased, alanine amino transferase increased,aspartate aminotransferase increased, platelet count decreased)

Rare side-effects which may affect less than 1 person in 1000 are listed below:

  • Changes in heart beat
  • Coldness of hands and feet
  • Cough, nasal congestion, runny nose, nose bleed, snoring
  • Abnormal sense of smell, changes in vision including tunnel vision, swinging vision, altered perception of depth, flashes of light, visual brightness
  • Dilated pupils, cross eyes, eye irritation
  • Fever, cold sweat, tightness of the throat
  • Inflammation of the pancreas
  • Difficulty in swallowing
  • Slow or reduced movement of the body
  • Difficulty with wrting properly
  • Hives
  • Increased fluid in the abdomen
  • Muscle damage
  • Neck pain
  • Breast pain, breast discharge, abnormal breast growth, painful or interrupted mentrual periods
  • High blood sugar
  • Weight loss
  • Elevated mood
  • Kidney failure, reduced urine volume
  • Changes in blood test results (decrease in blood potassium, increase in blood creatinine, decrease in white blood cell count including neutrophils)
  • Inappropriate behaviour

Additional reactions reported from post marketing experience include heart failure, changes in the recording of electrical changes (ECG) in the heart which correspond to heart rhythm disturbances,

fluid in the lungs, loss of consciousness, convulsions, hypersensitivity and allergic reactions (which may include swollen face, swollen tongue, difficulty breathing, itchiness, inflammation of the eyes (keratitis), vision loss and a serious skin reaction characterized by rash, blisters, peeling skin and pain), mental impairment, aggression, urinary retention, diarrhoea, headache, nausea, and feeling unwell.

If you experience swollen face or tongue or if your skin turns red and starts to blister or peel you should seek immediate medical advice.

Certain side effects may be more common, such as sleepiness, because patients with spinal cord injury may be taking other medicines to treat, for example, pain or spasticity, that have similar side effects to Pregabalin and the severity of these effects may be increased when taken together.

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

How should it be stored?

Keep LYRICA out of the reach and sight of children.

Do not use LYRICA after the expiry date which is stated on the carton or bottle.

This medicinal product does not require any special storage conditions.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

What is it?

Lyrica is a medicine that contains the active substance pregabalin. It is available as capsules (white: 25, 50 and 150 mg; white and orange: 75, 225 and 300 mg; orange: 100 mg; light orange: 200 mg) and as an oral solution (20 mg/ml).

What is it used for?

Lyrica is used to treat adults with the following conditions:

neuropathic pain pain due to nerve damage. Lyrica can be used in peripheral neuropathic pain, such as the pain experienced by diabetic patients or by patients who have had herpes zoster shingles, and central neuropathic pain, such as the pain experienced by patients who have had a spinal cord injury

epilepsy. Lyrica is used as an add-on to existing treatment in patients who have partial seizures epileptic fits starting in one specific part of the brain that cannot be controlled with their current treatment

generalised anxiety disorder long-term anxiety or nervousness about everyday matters.

The medicine can only be obtained with a prescription.

How is it used?

The recommended starting dose of Lyrica is 150 mg per day, divided into two or three doses. After three to seven days, the dose can be increased to 300 mg per day. Doses can be increased up to twice more until the most effective dose is reached. The maximum dose is 600 mg per day. Stopping treatment with Lyrica should also be done gradually, over at least a week.

The capsules should be swallowed whole with water. Patients who have kidney problems need to take lower doses.

How does it work?

The active substance in Lyrica, pregabalin, is similar in structure to the body’s own ‘neurotransmitter’ gamma-amino butyric acid (GABA), but has very different biological effects. Neurotransmitters are chemicals that allow nerve cells to communicate with each other. The exact way that pregabalin works is not fully understood, but it is thought to affect the way that calcium enters nerve cells. This reduces the activity of some of the nerve cells in the brain and spinal cord, reducing the release of other neurotransmitters that are involved in pain, epilepsy and anxiety.

How has it been studied?

Lyrica has been compared with placebo (a dummy treatment) in 22 studies:

for peripheral neuropathic pain, there were ten studies involving over 3,000 patients, about half of whom had diabetic neuropathy and half of whom had pain following shingles. A further study was carried out in 137 patients with central neuropathic pain due to a spinal cord injury. The studies lasted up to 12 weeks. The effectiveness of Lyrica was measured using a standard pain questionnaire

for epilepsy, there were three studies involving over 1,000 patients. The main measure of effectiveness was the change in the number of seizures after 11 to 12 weeks

for generalised anxiety disorder, there were eight studies involving over 3,000 patients. Effectiveness was measured using a standard anxiety questionnaire after four to eight weeks.

What benefits has it shown during the studies?

In neuropathic pain, Lyrica was more effective than placebo in decreasing pain. In peripheral neuropathic pain, 35% of the patients treated with Lyrica had a decrease in pain scores of 50% or more, compared with 18% of the patients treated with placebo. In central neuropathic pain, 22% of patients treated with Lyrica had a decrease in pain scores of 50% or more, compared with 8% of the patients treated with placebo.

In epilepsy, Lyrica reduced the number of seizures: about 45% of the patients taking 600 mg Lyrica a day and about 35% of those taking 300 mg Lyrica a day had a reduction in seizures of 50% or more. This compared with about 10% of the patients taking placebo.

In generalised anxiety disorder, Lyrica was more effective than placebo: 52% of the patients taking Lyrica had an improvement of 50% or more, compared with 38% of the patients taking placebo.

What is the risk associated?

The most common side effects with Lyrica (seen in more than 1 patient in 10) are dizziness and somnolence (sleepiness). For the full list of all side effects reported with Lyrica, see the Package Leaflet.

Lyrica should not be used in people who may be hypersensitive (allergic) to pregabalin or any of the other ingredients.

Why has it been approved?

The CHMP decided that Lyrica’s benefits are greater than its risks and recommended that it be given marketing authorisation.

Further information

The European Commission granted a marketing authorisation valid throughout the European Union for Lyrica to Pfizer Limited on 6 July 2004. The marketing authorisation is valid for an unlimited period.

For more information about treatment with Lyrica, read the Package Leaflet (also part of the EPAR) or contact your doctor or pharmacist.

This summary was last updated in 04-2010.