Can Lyrica (pregabalin) be taken with opioids?
Yes. Lyrica (pregabalin) can be taken with opioids, but the combination increases the risk of serious side effects—especially excessive sleepiness and breathing problems. Health authorities and prescribing information warn that using pregabalin with opioids can lead to respiratory depression and death in severe cases [1][2].
What specific risks come from combining pregabalin with opioids?
The main concerns are:
- Too much sedation (extreme drowsiness, slowed thinking)
- Breathing suppression (slower or weaker breathing)
- Increased risk of falls, confusion, and impaired coordination
These risks are specifically highlighted when pregabalin and opioid medicines are used together [1][2].
What symptoms should patients watch for?
If someone is taking Lyrica and an opioid and develops signs of opioid-like overdose or excessive central nervous system depression, they should seek urgent help. Concerning symptoms include:
- Severe drowsiness or difficulty staying awake
- Slow, shallow, or labored breathing
- Unresponsiveness or fainting
Because the combination can worsen breathing, breathing problems are especially important to take seriously [1][2].
How do clinicians reduce the danger if the combo is necessary?
Prescribers may:
- Start with lower doses and adjust gradually
- Limit how often or how much opioid is used
- Monitor closely for sedation and respiratory effects, especially when starting or changing doses
- Avoid other sedating medicines when possible
These steps align with warnings that the risk rises when both drugs are taken together [1][2].
Which opioids are most concerning?
The warning applies broadly to opioid use with pregabalin, not a single opioid product. The safest approach is to assume any opioid (for pain or cough) could increase risk of sedation and respiratory depression when combined with Lyrica [1][2].
Can I stop either medication because of this interaction?
Don’t stop abruptly without medical guidance, especially if you’re using either medication regularly. Talk with your clinician about dose changes or alternatives. Abrupt changes can cause withdrawal or symptom rebound, while the goal is to manage risk through supervision [1][2].
Is this interaction the same as with alcohol or benzodiazepines?
It’s similar in that combining Lyrica with other substances that depress the central nervous system can increase sedation and breathing risk. The specific boxed or major warnings focus on opioids, but other sedatives can further raise risk [1][2].
If you’re taking both, what should you do right now?
- Don’t change doses on your own.
- Contact your prescriber promptly to review the combination and whether your doses need adjustment.
- Seek emergency care if you notice severe drowsiness or breathing problems [1][2].
Sources
[1] https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022230s022lbl.pdf
[2] https://www.fda.gov/drugs/drug-safety-and-availability/fda-requires-boxed-warning-opioids-must-warn-about-serious-risks-use-gabapentinoids