pregabalin (Rx)

Brand and Other Names:Lyrica, Lyrica CR
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule: Schedule V

  • 25mg
  • 50mg
  • 75mg
  • 100mg
  • 150mg
  • 200mg
  • 225mg
  • 300mg

oral solution: Schedule V

  • 20mg/mL

tablet, extended-release: Schedule V

  • 82.5 mg
  • 165 mg
  • 330 mg

Diabetic Peripheral Neuropathic Pain

Regular-release capsules

  • Initial: 50 mg PO q8hr
  • Maintenance: May increase to 100 mg PO q8hr within 1 week, as needed; not to exceed 300 mg/day

Extended-release tablets

  • Initial: 165 mg PO qDay
  • Maintenance: May increase to 330 mg PO qDay within 1 week based on response and tolerability; not to exceed 330 mg PO qDay
  • See also Administration

Postherpetic Neuralgia

Regular-release capsules

  • Initial: 150-300 mg/day PO divided q8-12hr
  • Maintenance: May increase to 300 mg/day divided q8-12hr after 1 week, as needed

Extended-release tablets

  • Initial: 165 mg PO qDay
  • Maintenance: May increase to 330 mg PO qDay within 1 week based on response and tolerability; not to exceed 330 mg PO qDay
  • Patients experiencing insufficient pain relief following 2-4 weeks of treatment with 330 mg PO qDay and tolerate the ER tablets, may be treated with up to 660 mg PO qDay

Fibromyalgia

Regular-release capsules and oral solution only

Initial: 75 mg PO q12hr (150 mg/day)

Maintenance: May increase to 150mg q12hr after 1 week as needed; recommended dose is 300-400 mg/day

Owing to dose-dependent adverse reactions, doses >450 mg/day are not recommended

Partial Onset Seizures

Regular-release capsules and oral solution only

Indicated as adjunctive therapy for treatment of partial onset seizures

Initial: 150 mg/day PO divided q8-12hr

Maintenance: Based on clinical response and tolerability, may increase dose in weekly increments, not to exceed 600 mg/day

Efficacy of adjunctive pregabalin in patients taking gabapentin has not been evaluated in controlled trials; consequently, no dosing recommendations can be made when pregabalin is used with gabapentin

Neuropathic Pain With Spinal Cord Injury

Regular-release capsules and oral solution only

Initial: 75 mg PO q12hr (150 mg/day); may increase within 1 week to 300 mg/day PO divided q12hr

If there is insufficient pain relief after 2-3 weeks and 300 mg/day dose is tolerated, may increase dose again up to 600 mg/day PO divided q12hr

Dosage Modifications

Renal impairment (capsules/oral solution)

  • CrCl 30-60 mL/min
    • Decrease dose by 50% divided BID/TID
  • CrCl 15-30 mL/min
    • If 150 mg/day in normal renal function: Decrease dose to 25-50 mg/day; administer qDay or BID
    • If 300 mg/day in normal renal function: Decrease dose to 75 mg/day; administer qDay or BID
    • If 450 mg/day in normal renal function: Decrease dose to 100-150 mg/day; administer qDay or BID
    • If 600 mg/day in normal renal function: Decrease dose to 150 mg/day; administer qDay or BID
  • CrCl <15 mL/min
    • If 150 mg/day in normal renal function: Decrease dose to 25 mg/day; qDay
    • If 300 mg/day in normal renal function: Decrease dose to 25-50 mg/day; qDay
    • If 450 mg/day in normal renal function: Decrease dose to 50-75 mg/day; qDay
    • If 600 mg/day in normal renal function: Decrease dose to 75 mg/day; qDay
  • Supplemental dosage following hemodialysis
    • 25 mg qDay regimen: Take 1 supplemental dose of 25 mg or 50 mg
    • 25-50 mg qDay regimen: Take 1 supplemental dose of 50 mg or 75 mg
    • 50-75 mg qDay regimen: Take 1 supplemental dose of 75 mg or 100 mg
    • 75 mg qDay regimen: Take 1 supplemental dose of 100 mg or 150 mg

Renal impairment (ER tablets)

  • CrCl 30-60 mL/min
    • If 165 mg/day in normal renal function: Decrease dose to 82.5 mg/day
    • If 330 mg/day in normal renal function: Decrease dose to 165 mg/day
    • If 495 mg/day in normal renal function: Decrease dose to 247.5 mg/day
    • If 660 mg/day in normal renal function: Decrease dose to 330 mg/day
  • CrCl <30 mL/min or hemodialysis
    • Not recommended
    • Patients should only receive capsules or oral solution

Dosing Considerations

Conversion from capsules or oral solution (Lyrica) to ER tablets (Lyrica CR)

  • Lyrica total daily dose (TDD) 75 mg/day = Lyrica CR 82.5 mg/day
  • Lyrica TDD 150 mg/day = Lyrica CR 165 mg/day
  • Lyrica TDD 225 mg/day = Lyrica CR 247.5 mg/day
  • Lyrica TDD 300 mg/day = Lyrica CR 330 mg/day (3 × 82.5 mg tablets)
  • Lyrica TDD 450 mg/day = Lyrica CR 495 mg/day (3 × 165 mg tablets)
  • Lyrica TDD 600 mg/day = Lyrica CR 660 mg/day (2 × 330 mg tablets)

Dosage Forms & Strengths

capsule: Schedule V

  • 25mg
  • 50mg
  • 75mg
  • 100mg
  • 150mg
  • 200mg
  • 225mg
  • 300mg

oral solution: Schedule V

  • 20mg/mL

Partial Onset Seizures

Regular-release capsules and oral solution only

Indicated as adjunctive therapy for treatment of partial onset seizures in patients aged ≥1 month

<1 month: Safety and efficacy not established

≥1 month to <17 years

  • 11 kg to <30 kg
    • Initial: 3.5 mg/kg/day PO divided q8hr (for 1 month to 4 years) or q8-12hr (for ≥4 years)
    • Maintenance: Based on clinical response and tolerability, may increase dose in weekly increments, not to exceed 14 mg/kg/day
  • ≥30 kg
    • Initial: 2.5 mg/kg/day PO divided q8-12hr
    • Maintenance: Based on clinical response and tolerability, may increase dose in weekly increments up to 10 mg/kg/day (not to exceed 600 mg/day)

≥17 years

  • Initial: 150 mg/day PO divided q8-12hr
  • Maintenance: Based on clinical response and tolerability, may increase dose in weekly increments, not to exceed 600 mg/day

Fibromyalgia

Safety and efficacy not established

A 15-week, placebo-controlled trial (n=107) was conducted in pediatric patients with fibromyalgia aged 12-17 yr with pregabalin (75-450 mg/day)

The primary efficacy endpoint of change from baseline to Week 15 in mean pain intensity (derived from an 11-point numeric rating scale) showed numerically greater improvement for the pregabalin-treated patients compared to placebo-treated patients, but did not reach statistical significance

Dosage Modifications

Renal impairment: Use in children with compromised renal function has not been studied

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Interactions

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            Adverse Effects

            Dose-dependent; percentages according to highest reported

            >10%

            Lyrica CR

            • Dizziness (3.4-17.1%)
            • Somnolence (0.5-11.4%)

            Lyrica

            • Dizziness (8-45%)
            • Somnolence (lethargy, sluggishness, hypersomnia; 4-36%)
            • Peripheral edema (16%)
            • Ataxia (1-20%)
            • Fatigue (5-11%)
            • Xerostomia (1-15%)
            • Weight gain (16%)
            • Tremor (11%)
            • Blurred vision (1-12%)
            • Diplopia (12%)

            1-10%

            Lyrica CR

            • Vertigo (1-3.9%)
            • Headache (1.9-3.9%)
            • Vision blurred (0.5-3.7%)
            • Balance disorder (0.5-2.6%)
            • Weight increased (2.5-3.8%)
            • Fatigue (2.4-3.9%)
            • Constipation (2.7%)
            • Dry mouth (0.5-3.7%)
            • Nausea (3-3.4%)
            • Peripheral edema (3.8-4.9%)
            • Fatigue (1.4 -3.9%)
            • Joint swelling (1.9%)
            • Nasopharyngitis (1.4-1.5%)
            • ALT/AST increased (0.2-1.4%)
            • Diarrhea (1-1.4%)

            Lyrica

            • Asthenia (5%)
            • Edema (8%)
            • Facial edema (<3%)
            • Hypotension (2%)
            • Neuropathy (2-9%)
            • Pain (5%)
            • Disorientation (<2%)
            • Constipation (5%)
            • Weight gain (4%)
            • Accidental injury (4%)
            • Abnormal thinking (2%)
            • Confusion (<7%)
            • Amnesia (<6%)
            • Vertigo (1-4%)

            <1%

            Addiction

            Anemia

            Diarrhea

            Gynecomastia and breast enlargement

            Epididymitis

            Esophagitis

            Dysmenorrhea

            Dystonia

            Heart failure

            Hirsutism

            Uveitis

            Postmarketing Reports

            Angioedema

            Suicidal behavior and ideation

            Creatinine kinase

            Decreased platelet count

            Pneumonia

            Viral infection

            Bullous pemphigoid

            Respiratory depression

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            Warnings

            Contraindications

            Hypersensitivity

            Cautions

            Peripheral edema may occur; higher frequencies of weight gain and peripheral edema were observed in patients taking both pregabalin and a thiazolidinedione antidiabetic agent compared to patients taking either drug alone; monitor these patients for possible exacerbation of congestive heart failure symptoms when using pregabalin

            Pregabalin may cause dizziness and somnolence; inform patients that pregabalin may impair their ability to perform tasks such as driving or operating machinery; concomitant use of pregabalin with other central nervous system (CNS) depressants may exacerbate these effects; for patients 1 month to less than 4 years of age, somnolence includes related terms lethargy, sluggishness, and hypersomnia

            Weight gain may occur; long-term cardiovascular effects of pregabalin-associated weight gain are unknown

            Symptoms including, insomnia, nausea, headache, anxiety, and diarrhea were reported following abrupt or rapid discontinuation of treatment; increased seizure frequency may occur in patients with seizure disorders and have rapid discontinued treatment; taper pregabalin gradually over a minimum of 1 week rather than discontinuing the drug abruptly

            Unexpectedly high incidence of hemangiosarcoma was identified in 2 different strains of mice; the clinical significance of this finding is unknown

            In controlled studies, blurred vision and other vision-related events were reported with treatment; clinical significance of the ophthalmologic findings is unknown, inform patients to notify their physician if changes in vision occur; if visual disturbance persists, consider further assessment

            Creatine kinase elevations has been associated with treatment; monitor for symptoms (eg, unexplained muscle pain, tenderness, or weakness, particularly if these muscle symptoms are accompanied by malaise or fever); discontinue treatment if myopathy is diagnosed or suspected or if markedly elevated creatine kinase levels occur

            Serious, life-threatening, or fatal respiratory depression reported when coadministered with central nervous system depressants, including opioids, or in the setting of underlying respiratory impairment; consider initiating therapy at low dose and monitor for symptoms of respiratory depression and sedation if co-prescribing of another CNS depressant, like opioid, or prescribing to patients with underlying respiratory impairment

            Monitor for decreased platelet count (rare)

            May cause prolongation of PR interval

            Suicidal thoughts or behaviors

            • Antiepileptic drugs increase risk of suicidal thoughts or behavior in patients taking these drugs for any indication; monitor for emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior
            • Inform patients, their caregivers, and families of the increase the risk of suicidal thoughts and behavior; advise to be alert for the emergence or worsening of signs and symptoms

            Angioedema

            • Angioedema of the face, extremities, lips, tongue, glottis, and larynx has been reported during initial and chronic treatment, including reports of life-threatening angioedema with respiratory compromise requiring emergency intervention
            • If laryngeal stridor or angioedema of the face, tongue, or glottis occurs, discontinue therapy and institute appropriate therapy immediately
            • Coadministration of ACE inhibitors or mTOR (mammalian target of rapamycin) inhibitors (eg, temsirolimus, sirolimus, everolimus), or previous history of angioedema may increase risk
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            Pregnancy & Lactation

            Pregnancy

            There are no adequate and well-controlled studies with pregabalin in pregnant women

            Animal data

            • In the animal fertility study with pregabalin in male rats, adverse reproductive and developmental effects were observed
            • In animal reproduction studies, increased incidences of fetal structural abnormalities and other manifestations of developmental toxicity, including skeletal malformations, retarded ossification, and decreased fetal body weight were observed in the offspring of rats and rabbits given pregabalin orally during organogenesis, at doses that produced plasma pregabalin exposures (AUC) greater than or equal to 16 times human exposure at the maximum recommended dose (MRD) of 600 mg/day

            Pregnancy Registry

            • Monitors pregnancy outcomes in women exposed to pregabalin during pregnancy
            • Enroll pregnant patients in the North American Antiepileptic Drug (NAAED) Pregnancy Registry; contact 1-888-233-2334 or find more information at http://www.aedpregnancyregistry.org/

            Lactation

            Small amounts of pregabalin have been detected in the milk of lactating women

            Based on animal studies, there is a potential risk of tumorigenicity with pregabalin exposure via breast milk to the breastfed infant

            Available clinical study data in patients greater than 12 years of age do not provide a clear conclusion about the potential risk of tumorigenicity with pregabalin

            Because of the potential risk of tumorigenicity, breastfeeding is not recommended during treatment

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Precise mechanism of action unknown but is a GABA analogue that binds to a subunit of voltage-gated calcium channels in CNS; does not affect sodium channels, opiate receptors, or cyclo-oxygenase enzyme activity; interactions with descending noradrenergic and serotonergic pathways originating from the brain stem appear to reduce neuropathic pain transmission from spinal cord

            Absorption

            Bioavailability: >90%

            AUC (24 hr): 31.5 mcg·h/mL (75 mg capsule BID); 29.4 mcg·h/mL (165 mg ER tablet)

            Peak plasma concentration: 3.2 mcg/mL (75 mg capsule BID); 2 mcg/mL (165 mg ER tablet)

            Peak plasma time, fasting: 1.5 hr (capsule)

            Peak plasma time, with food: 3 hr (ER tablet)

            Steady-state is achieved within 24-48 hr

            Distribution

            Vd: 0.5 L/kg

            Protein bound: None

            Although there are no data in humans, pregabalin has been shown to cross the blood brain barrier in mice, rats, and monkeys

            Metabolism

            Minimal

            Elimination

            Half-life: 6.3 hr

            Clearance: 67-80.9 mL/min

            Excretion: Urine

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            Administration

            Oral Administration

            Capsules/oral solution

            • Take orally with or without food
            • When discontinuing treatment, taper gradually over a minimum of 1 week

            ER tablets

            • Take once daily after an evening meal
            • Swallow whole and should not be split, crushed, or chewed
            • When discontinuing treatment, taper gradually over a minimum of 1 week
            • Missed dose after an evening meal, then take usual dose prior to bedtime following a snack
            • Missed dose prior to bedtime, then take usual dose following a morning meal
            • Missed dose following the morning meal, then take usual dose at the usual time that evening following an evening meal

            Storage

            Store at 20-25°C (68-77°F), excursions permitted between 15-30°C (between 59-86°F) in the original package

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Lyrica oral
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            25 mg capsule
            Lyrica oral
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            75 mg capsule
            Lyrica oral
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            150 mg capsule
            Lyrica oral
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            50 mg capsule
            Lyrica oral
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            200 mg capsule
            Lyrica oral
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            100 mg capsule
            Lyrica oral
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            225 mg capsule
            Lyrica oral
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            300 mg capsule
            Lyrica oral
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            20 mg/mL solution
            pregabalin oral
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            50 mg capsule
            pregabalin oral
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            25 mg capsule
            pregabalin oral
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            pregabalin oral
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            75 mg capsule
            pregabalin oral
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            100 mg capsule
            pregabalin oral
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            75 mg capsule
            pregabalin oral
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            165 mg tablet
            pregabalin oral
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            82.5 mg tablet
            pregabalin oral
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            300 mg capsule
            pregabalin oral
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            225 mg capsule
            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            225 mg capsule
            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            225 mg capsule
            pregabalin oral
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            pregabalin oral
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            100 mg capsule
            pregabalin oral
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            75 mg capsule
            pregabalin oral
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            225 mg capsule
            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            330 mg tablet
            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            pregabalin oral
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            25 mg capsule
            pregabalin oral
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            200 mg capsule
            pregabalin oral
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            225 mg capsule
            pregabalin oral
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            300 mg capsule
            pregabalin oral
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            330 mg tablet
            pregabalin oral
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            165 mg tablet
            pregabalin oral
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            82.5 mg tablet
            pregabalin oral
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            100 mg capsule
            pregabalin oral
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            50 mg capsule
            pregabalin oral
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            75 mg capsule
            pregabalin oral
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            200 mg capsule
            pregabalin oral
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            100 mg capsule
            pregabalin oral
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            300 mg capsule
            pregabalin oral
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            225 mg capsule
            pregabalin oral
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            200 mg capsule
            pregabalin oral
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            150 mg capsule
            pregabalin oral
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            100 mg capsule
            pregabalin oral
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            50 mg capsule

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            Patient Handout

            Patient Education
            pregabalin oral

            PREGABALIN EXTENDED-RELEASE - ORAL

            (pree-GAB-a-lin)

            COMMON BRAND NAME(S): Lyrica CR

            USES: This medication is used to treat pain caused by nerve damage due to diabetes or shingles (herpes zoster) infection.

            HOW TO USE: Read the Medication Guide provided by your pharmacist before you start taking pregabalin and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth as directed by your doctor, usually once daily after an evening meal. Swallow the tablets whole. Do not split, crush, or chew. Doing so can release all of the drug at once, increasing the risk of side effects.The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects (such as dizziness and drowsiness), your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as difficulty sleeping, nausea, headache, and diarrhea. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Report any new or worsening symptoms right away.Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Take this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.Tell your doctor if your condition lasts or gets worse.

            SIDE EFFECTS: Drowsiness, dizziness, headache, dry mouth, nausea, constipation, and weight gain may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: vision changes (such as blurred vision), unusual bleeding/bruising, muscle pain/tenderness/weakness (especially with fever or unusual tiredness), swelling hands/ankles/feet.A small number of people who take anticonvulsants for any condition (such as seizure, bipolar disorder, pain) may experience depression, suicidal thoughts/attempts, or other mental/mood problems. Tell your doctor right away if you or your family/caregiver notice any unusual/sudden changes in your mood, thoughts, or behavior such as signs of depression, suicidal thoughts/attempts, thoughts about harming yourself.Get medical help right away if you have any very serious side effects, including: slow/shallow breathing.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking pregabalin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart failure), kidney disease, history of an allergic reaction which included itching/swelling of the face/lips/tongue/throat (angioedema), personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), breathing problems (such as COPD).This drug may make you dizzy or drowsy or cause blurred vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially slow/shallow breathing.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: orlistat.The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also cause drowsiness or breathing problems. Tell your doctor or pharmacist if you are using other products such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

            NOTES: Do not share this medication with others. Sharing it is against the law.Lab and/or medical tests (such as kidney function, platelet count) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

            MISSED DOSE: If you miss a dose and remember before bedtime, take it after a snack before bedtime. If it is the next morning when you remember, take the dose after the morning meal. If you remember after the morning, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised August 2021. Copyright(c) 2022 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.