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Sephira Med Centres

Scan · pregabalin

What is the labelled pregabalin ceiling above 150 mg?

Medically reviewed by Dr. Yuki Tanaka, MD - Clinical pharmacology, Toronto

Last reviewed · 3 min read · Updated

Bone review card, cobalt edge, lime chip: ceiling toward 600, 150 in front

The ceiling depends on the disease. Adult starts can begin at 150 mg per day. Diabetic nerve pain stops at 300 mg/day. Fibromyalgia often lives at 300-450 and is not recommended above 450. Postherpetic neuralgia, spinal-cord injury pain, and adult seizure adjunct can reach 600 mg/day in selected people who still hurt or still seize and who tolerate the climb. Kidneys shrink every column. Indication scan names the rows. Panel.

150 mg is a start, not a roof

This site locks 150 mg so scans share one number. The roof is a different job. Lock scan.

People rate 'it only worked at 450' after a DPN start and then wonder why edema and fog arrived together. Quote the indication before you quote a ceiling.

Why DPN stops at 300

Maximum recommended DPN dose is 300 mg/day when CrCl is at least 60 mL/min. 600 mg/day was studied and did not confer additional significant benefit; it was less well tolerated.

In view of dose-dependent adverse reactions, treatment above 300 mg/day is not recommended for that pain. A neighbor's SCI 600 is not a DPN plan.

Why fibromyalgia stops at 450

Recommended fibromyalgia dose is 300 to 450 mg/day. After 300, people who still lack benefit may go to 225 mg twice daily (450 mg/day). 600 mg/day was studied without extra benefit and with worse tolerance.

Doses above 450 mg/day are not recommended for fibromyalgia. Copying 600 from a seizure card onto a fibro card is a miss.

When 600 is a reserved climb

PHN: after 2 to 4 weeks at 300 mg/day, selected adults who still hurt and who tolerate Lyrica may go toward 600. SCI: after 2 to 3 weeks at 300 mg/day (150 mg twice daily), selected adults may go to 300 mg twice daily.

Adult seizure adjunct can also see 600 mg/day. Pediatric weight-based dosing has its own mg/kg roof and must not exceed 600 mg/day in heavier children. Do not split a 150 mg adult capsule onto a child.

Every roof shrinks with CrCl

The label table has 150 / 300 / 450 / 600 columns at CrCl at or above 60. The 30-60 row halves those columns. Lower rows shrink again. A 600 dream on 40 mL/min is not on the table.

Kidney scan. Hemodialysis extras do not open a normal-kidney 600.

Ceiling tag after the rows

DPN 300. Fibro 450. PHN, SCI, adult seizures can see 600 in selected adults. Watch ankles as the day climbs: edema watch.

Yuki Tanaka tags roofs after the indication table. Do not email a request to raise you to 600.

Sources

  1. DailyMed LYRICA (pregabalin) capsules
  2. US LYRICA prescribing information (Pfizer)

Checked against the current label and reviewed by Dr. Yuki Tanaka. See Scan, Tag, Board-check, Post.

Board thread

Answers follow the U.S. Lyrica label.

Pearl S., Bangor CrCl 45. Can I still aim at 300?

Board reply

The 30-60 column halves the normal-kidney totals. A 300 mg normal-kidney day becomes 150 mg/day in that row. Ask the clinician to place you on the table, not on a screenshot.

Vera J., Bellingham Pain clinic said 600. I have diabetic feet.

Board reply

DPN is not recommended above 300 mg/day. Ask whether the 600 is for a second indication or a leftover screenshot. Recalculate kidneys before anyone climbs.

Nico A., Huntsville Fibro at 450 still hurts. Go to 600 like PHN?

Board reply

Fibromyalgia is not recommended above 450 mg/day. 600 was studied without extra benefit. Talk about other tools. Do not copy a PHN reserve onto fibro.