Gabapentin vs Pregabalin: Side Effects, Dosages, & Differences

In the treatment of chronic nerve pain, epilepsy, or anxiety disorders, two drugs are generally used most of the time, which are Gabapentin and Pregabalin. Both drugs belong to the same class and share the same mechanism of action but exhibit variations in their efficacy, side effects, and usage. Both Gabapentin and Pregabalin are highly effective, and Gabapentin is more effective in pain reduction than Pregabalin.

In this blog, we will highlight some of the similarities and differences between Gabapentin vs Pregabalin side effects, dosage, and mechanism of action, and we will discuss Gabapentin vs Pregabalin to assist you and your patients in making the correct choice in deciding which drug is ideal for them. Once you read this blog, if you have queries regarding pregabalin vs gabapentin: which is better, is gabapentin and pregabalin the same thing, and can you take gabapentin and pregabalin at the same time? Then, ask your healthcare provider for better treatment and a healthier life.

Understanding Gabapentin and Pregabalin

To understand Gabapentin and Pregabalin, both gabapentinoid drugs class that are widely used to treat chronic nerve pain, seizures, and anxiety disorders.

Define Gabapentin

Gabapentin is the generic form of the brand-name drug Neurontin, and was originally developed to treat epilepsy. Gabapentin operates by binding to calcium channels to reduce glutamate release, a neurotransmitter that plays a role in pain transmission. Today, it is widely used to treat nerve pain, including postherpetic neuralgia and diabetic neuropathy, and off-label for fibromyalgia and anxiety.

Define Pregabalin

Pregabalin is also the generic name for the brand-name medication Lyrica, and it functions by attaching to a certain type of calcium channel within the central nervous system, which serves to limit the release of pain-signaling neurotransmitters. It relieves by stabilizing nerve impulses and is most often prescribed to relieve nerve pain, epilepsy, and generalized anxiety disorder.

Difference between Gabapentin and Pregabalin

Pregabalin and Gabapentin are antiepileptic drugs that are very effective in relieving severe pain like chronic nerve pain, epilepsy, or anxiety disorders, but they differ in cost, onset, and potency. Here are some points that show how pregabalin is different from Gabapentin.

• Pregabalin is an FDA-approved drug more beneficial than Gabapentin, but both are off-label.
• Both medications work similarly to reduce pain, but Pregabalin is absorbed quickly.
• Pregabalin is commonly known as a controlled substance, but in some states of the USA, Gabapentin is a controlled substance.
• Pregabalin is more effective than Gabapentin in some situations.
• Gabapentin and Pregabalin share similar side effects, but few differences are there according to their mechanism of action.
• Gabapentin is available at an affordable price than Pregabalin worldwide.

Gabapentin or Pregabalin: Which Works Better

When it comes to comparing the performance of Gabapentin and Pregabalin, both drugs perform better in reducing chronic nerve pain, epilepsy, or anxiety disorders. Some tips on who performs better are provided below:

Gabapentin vs Pregabalin for Neuropathic Pain

Gabapentin and Pregabalin are both commonly prescribed for neuropathic pain, but they differ slightly in their potency, absorption, and onset of action. Several studies suggest that Pregabalin is slightly effective than Gabapentin for neuropathic pain, including diabetic neuropathy and fibromyalgia.

Gabapentin vs Pregabalin for Sciatica

Both Gabapentin and Pregabalin are anticonvulsants and are usually prescribed for nerve-related pain, including sciatica, while Pregabalin tends to work faster and may provide more consistent pain relief than Gabapentin.

Gabapentin vs Pregabalin for anxiety

Pregabalin and Gabapentin are utilized off-label for anxiety, particularly generalized anxiety disorder (GAD). In comparing both drugs, Pregabalin has a quicker onset and reliable absorption, and thus can be more effective in acute anxiety control.

Gabapentin vs Pregabalin for nerve pain

Pregabalin and Gabapentin are anticonvulsants and widely prescribed for nerve pain, including conditions like diabetic neuropathy, postherpetic neuralgia, and fibromyalgia. While they work similarly by binding the calcium channel in the central nervous system, and reduce the risk of nerve pain.

Gabapentin vs Pregabalin: Mechanism of Action

Pregabalin and Gabapentin both operate by binding to the same type of mechanism of action, primarily binding the alpha2-delta(α2δ) subunit of voltage-gated calcium channels(VGCCs), specifically in the central nervous system.

Pregabalin has a greater affinity for binding to the α2δ subunit than Gabapentin, which could be responsible for its more intense and quicker action.

Should you take Gabapentin and Pregabalin together for pain

Taking Gabapentin and Pregabalin at the same time is generally not recommended by the healthcare provider. Both these drugs are classed under the gabapentinoid drugs and have a similar mechanism of action.

If you are taking both medications at the same time, it often increases the risk of side effects like dizziness, drowsiness, mood changes, or suicidal thoughts, and allergic reactions. In rare cases, a specialist (a pain management professional) may prescribe both together at the same time for short-term use, but this is an off-label strategy that is uncommon and closely monitored.

Side Effects: Gabapentin vs Pregabalin

Gabapentin and Pregabalin have the same side effects because they are both in the same class of gabapentinoid drugs. Some common side effects may include:

• Dizziness
• Drowsiness
• Fatigue
• Memory issues
• Blurred vision

Gabapentin-specific side effect:

• Swelling in the hands/feet
• Nystagmus (eye movement issues)
• Weight gain (less than Pregabalin)

Pregabalin-specific side effects:

• Weight gain
• Euphoria, which contributes to its abuse potential
• Dry mouth

Warnings and Precautions: Gabapentin or Pregabalin

Before using these medications, you should know about their potency, side effects, major warnings, and precautions. Some warnings and precautions are given:

• Avoid combining both medications with other CNS depressants unless it is necessary. If required, then use a lower effective dose.
• Do not suddenly stop medication without any suggestion from your healthcare provider.
• If you are consuming alcohol and other sedatives, then avoid them while taking these medications.
• If you are changing these medications, then consult your physicians immediately.

Frequently Asked Questions (FAQs)

Are Gabapentin and Pregabalin the same drug?

No, Gabapentin and Pregabalin are not the same drug. Although they belong to the same drug class and share a common mechanism of action but they differ in their potency, absorption, side effects, and how the body processes them.

Which is stronger: Gabapentin vs Pregabalin?

Pregabalin is stronger than Gabapentin. It binds tightly to the alpha-2-delta subunit of calcium channels in the central nervous system and is effective at a lower dose than Gabapentin.

Can I switch from Gabapentin to Pregabalin?

Yes, you can switch from Gabapentin to Pregabalin under your healthcare provider. Without any suggestion from your physician, if you switch, it may lead to many side effects, like dizziness and drowsiness.

How long until each medication works?

Pregabalin starts its work within 1 to 2 hours, and Gabapentin may take 3 to 4 hours to complete its work properly.

Which is safer for elderly patients?

Pregabalin is safer for elderly patients. Both medications are used for elderly patients, but Gabapentin may increase the risk of falls, confusion, and sedation.

Final Thoughts

After analyzing the similarities and differences between Gabapentin and Pregabalin, it is clear that both medications have their properties and applications. Selection between Gabapentin and Pregabalin should depend upon patients’ requirements, tolerance, and the doctor’s recommendations.