Q. What is the right dose of Pregabalin in fibromyalgia?

Answered by
Dr. Naval Mendiratta
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 24, 2016 and last reviewed on: Feb 10, 2020

Hello doctor,

My sister takes 225 mg Pregabalin for fibromyalgia at 7 PM, but it is not giving any relief from pain. She has severe back pain. We tried another 150 mg at 10 PM and the pain reduced fairly. What is the right dose and at what time it should be given? I am attaching her medicine list for your reference. Her vitamin D is 22 ng/mL. Please guide.

Dr. Naval Mendiratta

Rheumatology
#

Hi,

Welcome to icliniq.com.

  • I understand she is on Quetiapine and also on Effexor (Venlafaxine). I understand that they started it for depression or bipolar disorder.
  • Well, the other drugs you can consider for fibromyalgia are Duloxetine (Cymbalta), Amitriptyline and Mirtazapine. But, only after consulting your psychiatrist as all of them together can have some side effects.
  • Pregabalin beyond 225 mg may not make any effect now.
  • Also, she needs to start with meditation and yoga. All these medicines are for pain; eventually reach a saturation point after which you do not feel any effect.
  • So, one need to try other ways to peace out as well. Yoga along with meditation helps a lot. Also she can spend some time in hobby.

For further clarifications consult a rheumatologist online --> https://www.icliniq.com/ask-a-doctor-online/rheumatologist


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Hello doctor,

She took 400 mg one night and that was very good in relieving the pain. What is your idea if she takes 225 mg morning and 300 mg in the evening? Or 150 mg morning, 150 mg afternoon and 300 mg evening? As 600 mg is the maximum dosage and Pregabalin works on her, why do not we change the dose?

Dr. Naval Mendiratta

Rheumatology
#

Hi,

Welcome back to icliniq.com.

  • Well, that is quite a high dose of Pregabalin to be taken. Since it is a long-acting drug, there will not be a much point in taking it three times a day.
  • Better, she can take it 200 mg in the morning and 400 mg in the evening, so she gets good sleep also in the night.
  • Nevertheless, she needs to go for alternate therapies along with it before she reaches the saturation of this dose as well. So, if both go hand in hand, we can relieve her pain as this is a chronic problem which can linger on.

For further doubts consult a rheumatologist online --> https://www.icliniq.com/ask-a-doctor-online/rheumatologist


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