What liver effects can Lyrica (pregabalin) have?
Lyrica (pregabalin) is mainly cleared through the kidneys, so it is not commonly associated with direct liver injury. Still, liver-related effects have been reported in people taking pregabalin, including elevations in liver blood tests (like ALT/AST) and rare cases of drug-induced liver injury. [1]
What symptoms should you watch for?
If liver problems occur, symptoms can include yellowing of the skin or eyes (jaundice), dark urine, severe fatigue, nausea/vomiting, abdominal pain (especially upper right), and itching. Seek urgent medical care if these symptoms appear while taking Lyrica. [1]
How likely is liver damage with Lyrica?
Serious liver injury is considered uncommon. Most reported liver abnormalities with many medicines are mild lab changes that resolve after dose reduction or stopping the drug, but the key is not to ignore symptoms or significant lab rises. [1]
Does Lyrica change liver lab tests (ALT/AST)?
Reports include increases in liver enzymes in some patients. Clinicians may check liver-related labs if symptoms develop, if there are other liver risk factors, or if liver enzymes are already abnormal before starting or while taking the medication. [1]
Is it safer if you already have liver disease?
Liver disease changes drug safety mainly when a medicine is processed by the liver. Because pregabalin is primarily eliminated via the kidneys, dose adjustments are usually guided by kidney function more than liver function. People with liver disease should still tell their clinician about their condition, past hepatitis, cirrhosis, or prior drug reactions, and avoid alcohol if advised. [1]
Do other epilepsy medicines increase the risk?
Some epilepsy drugs are more likely than pregabalin to affect the liver. If Lyrica is used alongside other antiepileptic medicines, the overall liver risk may be higher and clinicians may monitor labs more closely. [1]
When should you contact a doctor urgently?
Contact your prescriber promptly for new jaundice, dark urine, severe or persistent nausea, or right-upper-abdominal pain. Go to urgent care or the emergency room if symptoms are intense, rapidly worsening, or accompanied by fever or confusion. [1]
What about alcohol and liver strain?
Alcohol can worsen liver injury from many causes, including medication reactions. Mixing alcohol with any drug that could affect the liver increases risk and can also worsen sedation and coordination problems from Lyrica. [1]
Sources
[1] Drug label information for Lyrica (pregabalin) liver-related warnings and adverse effects (including rare hepatic effects). https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm