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Neurontin or Lyrica? What’s the Difference?

By Rosanna Sutherby, PharmD

May 01, 2020

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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:

seizures
nerve pain related to shingles

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.

A 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.

Best Lyrica Rx Prices

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.

Best Neurontin Rx Prices

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/drug-information/

https://www.wellrx.com/health-conditions/about/health-condition/epilepsy/~default/

https://www.wellrx.com/health-conditions/about/health-condition/fibromyalgia/~default/

https://www.wellrx.com/pregabalin/drug-information/

https://www.wellrx.com/health-conditions/about/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,%20usa

https://www.wellrx.com/family-prescription-savings

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