Can pregabalin (Lyrica) cause a low heart rate (bradycardia)?
Pregabalin (Lyrica) can affect the nervous system and has been associated with heart-related side effects in some patients, including bradycardia (a slower-than-normal heart rate). If your heart rate has dropped after starting or increasing Lyrica, it’s important to treat that as a possible medication-related effect and contact your prescriber promptly.
Because “low heart rate” can also come from many other causes (dehydration, beta-blockers or other heart medicines, electrolyte problems, thyroid issues, infection, or rhythm disorders), medication timing alone doesn’t prove the cause—but it’s a strong reason to get checked.
When should I treat low heart rate as an emergency?
Seek emergency care now (or call your local emergency number) if low heart rate comes with any of the following:
- Fainting or near-fainting
- Chest pain, shortness of breath, or severe weakness
- Confusion or trouble staying awake
- A very slow pulse (for example, persistently under about 40 beats per minute) or rapidly worsening symptoms
If you have a smartwatch or monitor reading, repeat measurements after sitting quietly for a few minutes, but don’t delay urgent evaluation if symptoms are present.
What should I do if my pulse is low after starting Lyrica?
- Check your symptoms and heart rate pattern (resting vs. active, and whether it’s trending down).
- Contact the clinician who prescribed Lyrica as soon as possible, especially if the low heart rate started soon after beginning the drug or after a dose increase.
- Ask whether you should hold the next dose, reduce the dose, or switch to another therapy. Do not stop Lyrica abruptly without medical advice unless you were told to do so for safety reasons.
- Review all other medications with the prescriber, since combining drugs that slow heart rate can increase risk. Common examples include beta-blockers (like metoprolol), some calcium channel blockers (like verapamil/diltiazem), certain antiarrhythmics, and some other sedating or rhythm-affecting drugs.
Could Lyrica interact with other drugs that slow the heart?
Yes. Lyrica is often used alongside other medicines for pain, anxiety, sleep, or nerve conditions. Some of those medicines can lower heart rate indirectly (through sedation, dehydration, or lowering blood pressure), and others directly affect cardiac rhythm. The biggest practical step is a full med review by your prescriber or pharmacist.
What tests do doctors typically use to figure out why your heart rate is low?
Depending on your symptoms and how low your pulse is, clinicians may check:
- Blood pressure and orthostatic vitals (lying/standing)
- Electrolytes (potassium, magnesium, calcium)
- Thyroid function (TSH)
- Kidney function (drug handling and overall physiology)
- An EKG to look for rhythm issues
- Sometimes a Holter/event monitor if the abnormal rhythm is intermittent
Are there specific people who should be more cautious?
More caution is warranted if you have:
- Known rhythm problems (like atrial fibrillation with slow ventricular response, heart block, or sinus node dysfunction)
- A history of fainting or unexplained low heart rate
- Significant heart disease or heart failure
- Kidney problems (which can affect how the body clears pregabalin)
- Older age, where sensitivity to medication effects can be higher
What can patients do at home while waiting to be seen?
- Avoid driving or operating machinery if you feel lightheaded.
- Stay hydrated unless you were told to restrict fluids.
- Get resting pulse readings and note symptoms (dizziness, fatigue, chest discomfort, shortness of breath).
- Don’t add new over-the-counter medicines that can affect heart rate without checking first (especially those that cause dehydration, stimulate the heart, or add sedation).
Does stopping Lyrica fix the low heart rate?
In many cases, if Lyrica is contributing, reducing or stopping it (under prescriber guidance) can improve the heart rate. But the right decision depends on your underlying condition, your current dose, kidney function, and the presence of other rhythm or heart problems.
If you tell me your age, your Lyrica dose, when the low heart rate started (and whether it was after a dose change), your typical pulse range, and any symptoms (dizziness, fainting, shortness of breath, chest pain), I can help you figure out what level of urgency fits best and what questions to ask your clinician.