Neurontin and Lyrica for Migraine Prevention
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Using Neurontin or Lyrica for Migraine Prevention

Introduction

Migraines are typically moderate or severe. They can last as long as three days at a time. It is not known exactly why migraines happen. It is thought that certain brain chemicals play a role. One of these brain chemicals is called gamma-aminobutyric acid or GABA. GABA affects how you feel pain.

Drugs such as topiramate and valproic acid, which affect GABA, are commonly used to help reduce the number or severity of migraines, but they don’t work for everyone. To increase the number of options, newer drugs have been studied for use in migraine prevention. These drugs include Neurontin and Lyrica.

Neurontin is a brand name for the drug gabapentin, and Lyrica is a brand name for the drug pregabalin. The chemical structures of both of these drugs are similar to GABA. These drugs seem to work by blocking pain in the way GABA does.

Neurontin and Lyrica side by side

What is off-label drug use?
Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that has not been approved. However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think is best for your care.

Neurontin and Lyrica are not currently approved by the Food and Drug Administration (FDA) to prevent migraines. However, they can be used off-label for this purpose. Off-label use means that your doctor can prescribe a drug for a condition that it isn’t approved for if they think that you may benefit from the drug.

Because the use of Neurontin and Lyrica for migraine prevention is off-label, there isn’t a standard dosage. Your doctor will decide what dosage is right for you. Other features of these two drugs are listed in the following table.

Learn more: What you need to know about off-label prescription drug use »

Neurontin and Lyrica comparison

Effectiveness for migraine prevention

The American Academy of Neurology (AAN) is an organization that provides guidance for doctors about drugs for migraine prevention. The AAN has stated that there is not enough evidence at this time to support the use of Neurontin or Lyrica for migraine prevention.

However, some clinical trial results have shown a small benefit from the use of gabapentin (the drug in Neurontin) for migraine prevention. Likewise, results of some small studies have shown pregabalin (the drug in Lyrica) to be useful in preventing migraines. Your doctor may choose to prescribe either of these drugs if more commonly used drugs have not worked for you.

Read more: Detailed drug information for Neurontin (gabapentin) »

Cost, availability, and insurance coverage

Neurontin and Lyrica are both band-name drugs, so their costs are similar. Most pharmacies carry both of them. Neurontin is also available as a generic drug, which usually costs less. Check with your pharmacy for the exact cost of each of these drugs.

Many insurance providers cover Neurontin and Lyrica. However, your insurance may not cover these drugs for an off-label use, which includes migraine prevention.

Keep reading: Detailed drug information for Lyrica »

Side effects

The following table highlights the side effects of Neurontin and Lyrica. Some of the common side effects are also serious.

Neurontin and Lyrica comparison

**In children aged 3–12 years

Interactions

Neurontin and Lyrica can interact with other drugs or other substances you may take. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well. Substances that interact with Neurontin, Lyrica, or both drugs are listed in the following table.

Neurontin and Lyrica comparison

Use with other medical conditions

Your doctor must consider other medical conditions that you have before prescribing you Neurontin or Lyrica for migraine prevention.

Kidney disease

Your kidneys remove Neurontin or Lyrica from your body. If you have kidney disease or a history of kidney disease, your body may not be able to remove these drugs very well. This may increase the levels of the drug in your body and increase your risk of side effects.

Heart disease

Lyrica can cause unexpected weight gain and swelling of your hands, legs, and feet. If you have heart disease, including heart failure, these effects may worsen your heart function.

Talk with your doctor

Neurontin or Lyrica may be an option to prevent your migraines, especially if other drugs have not worked. Talk to your doctor about all of your options. Your doctor knows your medical history and call tell you the treatment that has the best chance of working for you.

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