Pregabalin

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Date: April 2022, Version 5

What is it?

Pregabalin (Lyrica®) is used to treat epilepsy, some types of nerve pain, and anxiety.

Benefits

What are the benefits of taking pregabalin in pregnancy?

Pregabalin prevents seizures in women with epilepsy, which can be dangerous and also lead to pregnancy complications. Pregabalin can improve nerve pain and anxiety, both of which can severely affect quality of life.

Risks

Are there any risks of taking pregabalin during pregnancy?

Two studies have suggested that there is a slightly increased chance of birth defects in the baby following use of pregabalin in early pregnancy. Other studies do not agree with this and overall, it is very clear that the vast majority of pregnant women using pregabalin will have a healthy baby.

One study has suggested that pregabalin use in later pregnancy might increase the chance of preterm birth. Ongoing research is required because it is unclear if this is a direct effect of pregabalin itself, or whether the underlying conditions that pregabalin is used to treat may increase the likelihood of the baby being delivered early.

As a precaution, pregabalin is only prescribed in pregnancy when the benefits outweigh these possible risks.

Pregabalin is an anti-epileptic drug and some of these can affect folic acid levels. Women taking pregabalin while trying to conceive and during pregnancy should therefore be prescribed a high dose folic acid supplement (5 mg/day).

Alternatives

Are there any alternatives to taking pregabalin?

Possibly. Other medicines can be used to treat epilepsy, nerve pain and anxiety; however, where a woman’s illness is well-controlled with pregabalin, staying on it may be the best option.

Ideally, women planning a pregnancy should speak to their GP or specialist to determine whether pregabalin is still the best medicine for them. Women with an unplanned pregnancy while taking pregabalin should be reviewed at the earliest opportunity by their GP or specialist.

No treatment

What if I prefer not to take medicines during pregnancy?

It is very important to take any medicines prescribed to treat epilepsy. Uncontrolled seizures can be serious and can lead to pregnancy complications. It is also very important that nerve pain and anxiety are controlled so that women are as well as possible during pregnancy and while looking after a baby.

Your doctor will only prescribe medicines when absolutely necessary and will be happy to talk to you about any concerns that you might have.

Do not stop pregabalin without speaking to your midwife, GP, or specialist.

Will my baby need extra monitoring?

All pregnant women in the UK will be offered a very detailed anomaly scan at around 20 weeks of pregnancy as part of their routine antenatal care. No extra monitoring for major birth defects is required following pregabalin use in pregnancy.

Are there any risks to my baby if the father has taken pregabalin?

We would not expect any increased risk to your baby if the father takes pregabalin.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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