Lyrica (pregabalin) is a brand-name prescription drug used to treat the following conditions in certain people:

As with other medications, Lyrica can interact with alcohol and certain other drugs. It can also interact with some herbal supplements. An interaction occurs when one substance causes another substance to have a different effect than expected.

For details about Lyrica’s interactions, keep reading. For additional information about Lyrica, including details about its uses, see this article.

Note: This article focuses only on Lyrica. Another drug called Lyrica CR is available but is not discussed here. Lyrica CR is used to treat some of the same conditions as Lyrica. The two medications both contain pregabalin and have similar interactions. To learn more about how Lyrica and Lyrica CR compare, talk with your doctor or pharmacist.

In some cases, a factor or condition could prevent your doctor from prescribing Lyrica due to the risk of harm. This is known as a contraindication. The contraindications of Lyrica include:

Having had an allergic reaction to Lyrica or any of its ingredients

If you have had an allergic reaction to Lyrica or any of its ingredients, your doctor will likely not prescribe Lyrica. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Note: Before you start treatment with Lyrica, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Lyrica.

It’s best to avoid drinking alcohol while you’re taking Lyrica.

Alcohol and Lyrica can cause some of the same side effects, including sleepiness, dizziness, and impaired coordination. Consuming alcohol during Lyrica treatment may increase your risk of these side effects or cause them to be more serious if they occur.

If you drink alcohol, it’s important to talk with your doctor before you begin taking Lyrica.

Before you start treatment with Lyrica, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Lyrica. Keep in mind that this chart does not include all drugs that may interact with Lyrica. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug nameDrug examplesInteraction result with Lyrica
buprenorphine and naloxone (Suboxone)can increase the risk of side effects from Lyrica*
cyclobenzaprine (Amrix)can increase the risk of side effects from Lyrica*
hydroxyzine (Vistaril)can increase the risk of side effects from Lyrica*
quetiapine (Seroquel)can increase the risk of side effects from Lyrica*
gabapentin (Neurontin)can increase the risk of side effects from Lyrica* and gabapentin
thiazolidinediones• pioglitazone (Actos)
• rosiglitazone (Avandia)
can increase the risk of side effects from Lyrica*
opioidstramadol (Ultram, others)
• methadone (Methadose)
can increase the risk of side effects from Lyrica* and opioids
“sleep” drugs• zolpidem (Ambien)
• eszopiclone (Lunesta)
can increase the risk of side effects from Lyrica* and sleep drugs
benzodiazepines• alprazolam (Xanax)
• clonazepam (Klonopin)
can increase the risk of side effects from Lyrica* and benzodiazepines

* For information about Lyrica’s side effects, see this article.

Here’s a closer look at certain drug interactions of Lyrica.

Gabapentin

The drug gabapentin (Neurontin) can interact with Lyrica. Gabapentin is prescribed to treat nerve pain after having shingles. Gabapentin is also used to treat partial onset seizures when used in combination with other seizure drugs.

Interaction result. Taking gabapentin and Lyrica together can increase the risk of side effects from both of these medications.*

Interaction explained. Gabapentin and pregabalin (the active drug in Lyrica) are very similar drugs. They can cause many of the same side effects, including serious ones such as respiratory depression (shallow, slow breathing). Taking the combination of gabapentin and Lyrica can make you more likely to have side effects from both medications.

Steps you or your doctor may take. Due to this risk, doctors typically will not prescribe gabapentin and Lyrica together. They can talk with you about other treatment options that may be better choices.

If your doctor feels it’s necessary for you to take gabapentin and Lyrica, they’ll likely prescribe the lowest possible dose of each medication.† They’ll also monitor you closely for side effects.

* For information about Lyrica’s side effects, see this article.
† To learn about the dosage of Lyrica, see this article.

Tramadol

Tramadol (Ultram, ConZip) is an opioid pain reliever that can interact with Lyrica.

Interaction result. Taking tramadol and Lyrica together can increase the risk of side effects from both drugs.*

Interaction explained. Tramadol and Lyrica can cause some of the same side effects, including serious ones such as respiratory depression. The combination of tramadol and Lyrica can increase your risk of side effects from both medications. Also, taking Lyrica with an opioid, such as tramadol, may increase the risk of an opioid overdose.

Steps you or your doctor may take. Due to this risk, doctors will typically prescribe tramadol with Lyrica only if both of the following apply:

  • The combination is the best treatment for you.
  • Other treatments would not work for your condition.

In this situation, your doctor will prescribe the lowest possible dose of both tramadol and Lyrica* that works to treat your condition. They’ll also monitor you very closely for side effects, especially any symptoms of respiratory depression, such as confusion or fatigue.

As a precaution, your doctor may recommend keeping naloxone (Narcan) nasal spray on hand. The drug is used as an emergency treatment for a known or suspected opioid overdose. Narcan works to reverse the effects of opioids, including respiratory depression. Your doctor can write you a prescription for Narcan, or you can request it at your local pharmacy. For more information about Narcan, talk with your doctor or pharmacist.

* For information about Lyrica’s side effects, see this article.
† To learn about the dosage of Lyrica, see this article.

Suboxone

Buprenorphine/naloxone (Suboxone) is prescribed to treat opioid use disorder. Suboxone can interact with Lyrica if these medications are taken together.

Interaction result. Taking the combination of Suboxone and Lyrica can increase the risk of side effects from both medications.*

Interaction explained. Suboxone and Lyrica can cause some of the same side effects. These include serious side effects such as respiratory depression. Taking Suboxone and Lyrica together may increase your risk of developing side effects from both drugs.

Steps you or your doctor may take. Because of this risk, doctors will prescribe Suboxone and Lyrica together only if both of the following apply:

  • It’s the best treatment for you.
  • Other treatments would not work to treat your condition.

In this case, your doctor will prescribe the lowest possible dose of Suboxone and Lyrica† that works for you. They’ll also monitor you very closely for side effects, especially any symptoms of respiratory depression, such as confusion or fatigue.

* For information about Lyrica’s side effects, see this article.
† To learn about the dosage of Lyrica, see this article.

Lyrica may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Lyrica.

Lyrica interactions with supplements

Before you start treatment with Lyrica, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Lyrica interactions with herbs

Lyrica can interact with the herb valerian root. This root is often used to relieve anxiety.

Both valerian root and Lyrica can cause some of the same side effects, including sleepiness and dizziness.* Taking valerian root and Lyrica together can increase your risk of these side effects.

Before you start taking Lyrica, it’s important to let your doctor know if you take valerian root. They’ll likely monitor you closely for side effects. Your doctor may suggest you stop taking valerian root if you feel severely sleepy or dizzy during Lyrica treatment.

* For information about Lyrica’s side effects, see this article.

Lyrica and vitamins

There have been no specific reports of Lyrica interacting with vitamins. However, it’s still important to check with your doctor or pharmacist before taking any of these products during Lyrica treatment.

Lyrica and food

You may wonder whether Lyrica interacts with certain foods and drinks, such as grapefruit or beverages containing caffeine.

No foods or drinks have been reported to interact with Lyrica. If you’d like to learn more about consuming certain foods or beverages during treatment with Lyrica, talk with your doctor or pharmacist.

Lyrica and vaccines

Lyrica is not known to interact with any vaccines. You can talk with your doctor or pharmacist if you have questions about receiving vaccines while you’re taking Lyrica.

Lyrica and lab tests

There have not been any reports of Lyrica interacting with lab tests. Your doctor or pharmacist can help answer questions you may have about lab tests during Lyrica treatment.

Lyrica interaction with cannabis or CBD

Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Lyrica. Specifically, CBD can increase the risk of certain side effects from taking Lyrica, including excessive sleepiness or dizziness. (For information about Lyrica’s side effects, see this article.)

Before you start treatment with Lyrica, tell your doctor and pharmacist if you take cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Lyrica. Before you take Lyrica, be sure to talk with your doctor about your health history. Lyrica may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Lyrica include:

  • Breathing problems. In rare cases, Lyrica can cause respiratory depression as a side effect, which can be life threatening.* If you already have a breathing problem, you may have an increased risk of this side effect if you take Lyrica. Examples of breathing problems include chronic obstructive pulmonary disease (COPD) and asthma. Your doctor can advise you on whether it’s safe to take Lyrica or if another treatment would be a better choice.
  • Heart problems. Lyrica can cause fluid retention and swelling in your hands, feet, and legs.* If you already have a heart problem, such as congestive heart failure, fluid retention and swelling could worsen your condition. In addition, Lyrica can also cause long QT syndrome, which may worsen existing heart conditions. Your doctor can help determine whether Lyrica is safe to take based on your heart health and any heart problems you may have.
  • Kidney problems. After you take a dose of Lyrica, your kidneys help get rid of the drug. If you have kidney problems, such as chronic kidney disease, your body may not get rid of Lyrica as well. This can cause the level of the medication to build up in your body, which may increase your risk of side effects.* If you have a kidney problem, your doctor will likely prescribe a lower Lyrica dose.
  • History of alcohol or drug misuse. For some people, Lyrica can cause a “high” feeling or euphoria (intense excitement or happiness).* The drug is sometimes misused to experience these sensations. If you have a history of alcohol or drug misuse, be sure to talk with your doctor before you begin Lyrica treatment. They can advise you on whether it’s safe for you to take the medication.
  • Pregnancy. It’s not known if it’s safe to take Lyrica while pregnant. If you’re pregnant or planning to become pregnant, talk with your doctor before starting Lyrica treatment. For more information, see this article.
  • Breastfeeding. Breastfeeding while taking Lyrica is not recommended. Talk with your doctor about safe feeding options for your child or other treatments for your condition. To learn more, see this article.
  • Allergic reaction. If you’ve had an allergic reaction to Lyrica or any of its ingredients, your doctor will likely not prescribe Lyrica. To learn more, see “When to avoid Lyrica” above.
  • Depression and other mental health conditions. Like other seizure drugs, taking Lyrica may increase the risk of suicidal thoughts or behaviors. If you currently have a mental health condition, such as depression, you may have a higher risk of this side effect than usual. It’s important to talk with your doctor about whether Lyrica is safe to take based on your mental health.

* For information about Lyrica’s side effects, see this article.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

Here are some frequently asked questions about Lyrica and possible interactions.

Does Lyrica interact with SSRIs, such as Lexapro?

Lyrica is not known to interact with selective serotonin reuptake inhibitors (SSRIs), such as escitalopram (Lexapro). SSRIs are a class of drugs used to treat depression and other mental health conditions.

Both Lyrica and SSRIs may increase your risk of bleeding. In theory, taking these two medications together could increase this risk further. However, there have been no reports of this occurring when these medications were taken in combination.

Your doctor and pharmacist can help answer additional questions you may have about SSRIs and Lexapro.

Can I take Lyrica with Cymbalta?

In general, yes. Lyrica and duloxetine (Cymbalta) are believed to be safe to take together. Cymbalta is a drug that’s used to treat anxiety, depression, and certain types of pain.

Both Lyrica and Cymbalta can increase the risk of bleeding. Because of this, it’s assumed that taking these medications in combination could further increase the bleeding risk. Yet, there have not been any reports of this occurring when Lyrica and Cymbalta were taken together.

If you have additional questions about Lyrica and Cymbalta, talk with your doctor or pharmacist.

Are there interactions between Lyrica and NSAIDs, such as ibuprofen?

There are possible potential interactions between Lyrica and pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs). However, it’s generally safe to take Lyrica with an NSAID. An example of an NSAID is ibuprofen (Advil, Motrin).

NSAIDs can increase your risk of bleeding, and so can Lyrica. It’s reasonable to believe that taking these medications together could further increase the risk. However, this interaction has not been reported with Lyrica and an NSAID.

If you’re taking Lyrica and feel you need a pain reliever, you can ask your doctor or pharmacist to recommend one. They may suggest an NSAID or a different drug.

You can take certain steps to help prevent interactions with Lyrica. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol or take cannabis.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the label of Lyrica and other paperwork that comes with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or prescribing information, may contain details about interactions. If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

You can also help prevent interactions with Lyrica by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Lyrica. These resources might help:

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.