In pain management, understanding which medications can be safely used together is crucial for both safety and effectiveness. Pregabalin, a prescription medication, is widely used in the treatment of chronic pain conditions. If you are taking Pregabalin for nerve pain, epilepsy, or anxiety, you may still experience other types of pain, like headaches, muscle aches, or injuries that Pregabalin alone doesn’t address. In these cases, you might wonder: What painkillers can I safely take with Pregabalin?

Here, we will discuss which over-the-counter and prescription pain relievers are generally considered safe to combine with Pregabalin, as well as which ones to avoid.

What Is Pregabalin?

Pregabalin is an essential drug in the world of neurological and pain management. Known primarily by its brand names Lyrica and Nervigesic, it is a prescription medication classified as an anticonvulsant and a neuropathic pain agent. Nervigesic is an affordable alternative to Lyrica and is available in several dosage strengths, with Nervigesic 75 mg being recommended for beginners.

Pregabalin has gained approval from the U.S. Food and Drug Administration for various uses, including the management of neuropathic pain linked with postherpetic neuralgia, diabetic peripheral neuropathy, and fibromyalgia. It is also approved as an adjunctive therapy for adults experiencing artial-onset seizures [1].

Why People Take Additional Pain Medications With Pregabalin?

Pregabalin is commonly combined with other analgesics because pain, especially chronic and neuropathic pain, is often complex and challenging to manage with a single medication.

While Pregabalin is effective in managing nerve-related pain, it may not provide complete relief when the pain has various sources or involves mechanical injury, inflammation, or emotional components.

Therefore, medications like NSAIDs, muscle relaxants, and opioids are sometimes added to enhance pain control through different working mechanisms. This approach is known as combination therapy, which enables better overall effectiveness while using a lower dose of each drug. This helps reduce the risk of side effects associated with a high dose of a single medication.

What Painkillers Can I Take with Pregabalin?

Many research studies have been conducted to determine the Pregabalin interactions

with various pain medications. It’s essential to note that the interaction can vary depending on the dosage and type of pain medication used [2].

Over-the-Counter Pain Relievers

Acetaminophen (Tylenol)

Acetaminophen, sold under the brand name Tylenol, is one of the safest pain relief medications to take with Pregabalin. It works effectively for mild to moderate pain and does not interfere with the effectiveness of Pregabalin. People can take it as per the recommended dosage without concern for significant drug interactions.

Ibuprofen

Many people wonder about combining ibuprofen and Pregabalin to relieve pain.

Ibuprofen belongs to a non-steroidal anti-inflammatory drug, a common choice for joint and muscle pain and headaches.

Typically, healthcare professionals prescribe Pregabalin in Combination with Ibuprofen. However, close medical monitoring is recommended, especially if the patient’s liver or kidneys are already compromised.

Prescription Painkillers

Opioid Pain Medications 

Opioid pain medications such as Codeine or Tramadol can sometimes be prescribed alongside Pregabalin to manage severe pain. However, both Pregabalin and opioids act on the central nervous system and may cause side effects like dizziness, drowsiness, or even respiratory depression in high amounts. Therefore, patients should strictly adhere to their doctor’s instructions when taking codeine with Pregabalin.

What Not To Take With Pregabalin?

Central nervous system depressants

Medications such as benzodiazepines, sedatives, and specific muscle relaxants should be avoided unless specifically prescribed. Combining these medications with Pregabalin increases the risk of confusion, drowsiness, and breathing difficulties.

The US Food and Drug Administration in December 2019 warned about serious breathing issues for those combining Pregabalin with central nervous system depressants or for those with lung problems [3].

High-Dose Aspirin

While a low dose of Aspirin, when combined with Pregabalin, is generally safe and no drug interaction was found between the two, high doses may increase the risk of adverse effects such as stomach bleeding when taken with Pregabalin. Stomach bleeding is especially seen in patients with gastrointestinal issues [4].

Gabapentin

Both Gabapentin and Pregabalin work on addressing nerve pain, and taking them together without medical supervision can increase the risk of side effects such as excessive sedation and dizziness [5].

Other Medications to Consider

Apart from pain medicine, Pregabalin can also interact with other medications and cause several adverse effects. These include:

• Antihistamines
• Certain Blood Pressure Medications (ACE inhibitors)
• Sleep medications.

Alcohol and Recreational Drugs: Additional Risks with Pregabalin

In addition to interactions with other drugs, there are different types of Pregabalin interactions, including:

Consuming alcohol can often cause unsteady movement, inability to react quickly, disturbed perceptions, and impaired motor control. Side effects of Pregabalin when combined with alcohol can be enhanced with even more central nervous system depression that can cause excessive sedation, an increased risk of falls, and a greater risk of accidental injury [6].

Cannabis, also known as marijuana and cannabis products, such as cannabidiol (CBD), have been reported to interact with Pregabalin. Taking Pregabalin with cannabis or cannabis products may lead to excessive drowsiness [7].

The Role of a Healthcare Professional in Managing Drug Interactions

Health care professionals play an important role in managing drug interactions by [8]:

• Managing any resultant side effects
• Ensuring medications are used safely
• Tracking potential drug interactions
• Ensuring medications are used safely.

Healthcare providers can effectively manage the risk of drug interaction involving Pregabalin through strategies like:

• Tailoring dosages appropriately
• Avoiding specific combinations
• Timing doses adequately
• Vigilantly monitor for early signs of side effects.

Potential Side Effects When Combining Pregabalin with Painkillers

Combining Pregabalin with pain medications could lead to various side effects such as:

• Nausea
• Diarrhea
• Headaches
• Drowsiness
• Lightheadedness
• Blurry vision
• Mood swings

Apart from these side effects, some people may experience more severe adverse effects, such as profound dizziness, hallucinations, and loss of consciousness.

Coping Strategies For Mild Side Effects

Mild side effects associated with Pregabalin and pain medication usage can interfere with your daily activities. There are numerous methods to alleviate them.

For example, when experiencing fatigue, drowsiness, or lightheadedness, refrain from handling heavy machinery, such as driving, and allow your body time to adapt.

In case of diarrhea, drink plenty of water. If your symptoms persist, seek medical assistance for alternative treatments.

For headaches, stay hydrated, get adequate rest, and consult a pharmacist about suitable pain relief options when needed.

Conclusion

While combating pain using medications such as Pregabalin, the process can become complicated if additional analgesics, or recreational drugs, come into play. Consulting a healthcare professional is essential to ensure the safe administration of medications and to manage any side effects that may arise effectively.

Careful supervision of your medicine regimen, being aware of possible drug interactions, are important factors in a practical approach to pain management.