What precautions matter when taking Lyrica (pregabalin) with opioids?
Yes. Combining Lyrica (pregabalin) with opioids increases the risk of serious side effects—especially slowed or stopped breathing (respiratory depression), extreme sleepiness, and loss of consciousness. Because of that, clinicians generally treat the combination as high risk and use added caution, closer monitoring, and dose adjustments when it’s necessary. [1]
Why does the combination raise risk?
Both medicines can depress the central nervous system. Opioids can slow breathing and cause sedation. Lyrica can also cause dizziness and drowsiness and may contribute to sedation and respiratory depression when used together. The combined effect is why the risk is higher than either drug alone. [1]
What should patients watch for?
Patients are typically advised to seek urgent help if they develop signs of excessive sedation or breathing problems, such as:
- unusual or hard-to-wake sleepiness
- slowed, shallow, or difficult breathing
- confusion, fainting, or loss of consciousness [1]
What can clinicians do to make the combination safer?
Common precautions include:
- using the lowest effective doses of each medicine
- avoiding unnecessary sedatives (for example, additional sleep medicines or benzodiazepines) when possible
- monitoring more closely during the start of therapy and after dose changes
- reassessing whether the opioid is still needed if sedation or breathing risk increases [1]
Are there specific situations where extra caution is needed?
Risk can be higher in people who already have breathing problems (such as sleep apnea or chronic lung disease) or who use other substances that depress the nervous system. Those situations typically call for extra caution and monitoring if an opioid and Lyrica must be combined. [1]
What should you do if you already take both?
Don’t stop either medication suddenly without medical guidance, but contact your prescriber promptly to review the regimen—especially if you feel unusually drowsy, dizzy, or notice any breathing-related symptoms. If breathing is slow or you cannot stay awake, treat it as an emergency and seek immediate help. [1]
Sources:
[1] FDA safety communication / prescribing information for opioids and warnings about serious risks when gabapentinoids (including pregabalin/Lyrica) are used with opioids (see FDA labeling language): https://www.fda.gov/