What’s the difference between Lyrica and hydrocodone?

What is Lyrica? What is hydrocodone?

Lyrica (pregabalin) is an oral medication chemically related to gabapentin (Gralise, Neurontin) used to treat pain caused by neurologic diseases such as postherpetic neuralgia as well as seizures. It also is used to treat fibromyalgia.

Hydrocodone is an opioid narcotic pain reliever similar to oxycodone, morphine, methadone, fentanyl, and other opioids prescribed for the long-term treatment of severe pain for which other treatment options are not effective, not tolerated, or would most likely not be strong enough to adequately manage the pain.

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What are the side effects of Lyrica and hydrocodone?

Lyrica

WARNING

Antiepileptic medications have been associated with increased risk of suicidal thinking and behavior. Anyone considering the use of antiepileptic drugs must balance this risk of suicide with the clinical need. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.

The most common side effects of Lyrica are

Other side effects include

  • constipation,
  • increased appetite,
  • nausea,
  • flatulence,
  • amnesia,
  • disorientation,
  • myoclonus (sudden, involuntary jerking of a muscle or muscle groups),
  • heart failure,
  • low blood pressure,
  • vomiting,
  • reduced blood platelet counts, and
  • increased blood creatinine kinase levels.

Increased creatinine kinase can be a sign of muscle injury, and in clinical trials, three patients experienced rhabdomyolysis (severe muscle injury). Therefore, patients should report unexplained muscle pain, tenderness or weakness to their doctors, especially if associated with fever and malaise (reduced well-being). Lyrica has rarely been associated with angioedema (swelling of the face, tongue, lips, and gums, throat and larynx).

Hydrocodone

The most frequent adverse reactions include:

  • Lightheadedness
  • Dizziness
  • Sedation
  • Nausea
  • Vomiting

Other side effects include:

  • Drowsiness
  • Constipation
  • Spasm of the ureter, which can lead to difficulty in urinating.

Other patient warnings include:

  • Hydrocodone can impair thinking and the physical abilities required for driving or operating machinery.
  • Hydrocodone is habit forming. Mental and physical dependence can occur when used long-term.
  • Hydrocodone can depress breathing and should be used with caution in elderly, debilitated patients, and in patients with serious lung disease.

Chronic Pain Syndrome: Treatment and Management for CPS

Can I get addicted to Lyrica or hydrocodone?

Lyrica

Addiction is not a listed side effect for Lyrica.

Hydrocodone

Hydrocodone exposes users to risks of addiction, abuse, and misuse, which can lead to overdose and death. Assess patient’s risk before prescribing, and monitor regularly for these behaviors and conditions.

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What is the dosage for Lyrica vs. hydrocodone?

Lyrica

  • Lyrica may be taken with or without food.
  • Treating diabetic peripheral neuropathy: The initial dose for neuropathic pain associated with diabetic peripheral neuropathy is 50 mg three times a day (150 mg/day). The dose may be increased to a maximum dose of 100 mg 3 times daily (300 mg/day) after one week.
  • Treating postherpetic neuralgia: The recommended dose for postherpetic neuralgia is 75-150 mg twice daily or 50-100 mg three times daily. Dosing should begin at 75 mg two times a day or 50 mg three times a day (150 mg/day). The dose may be increased to 100 mg 3 times daily (300 mg/day) after one week. If pain relief is inadequate after 2-4 weeks of treatment at 300 mg/day, the dose may be increased to 300 mg twice daily or 200 mg three times daily. Doses greater than 300 mg cause more side effects.
  • Treating neuropathic pain associated with spinal cord injury: The dose for treating neuropathic pain associated with spinal cord injury is 150 to 600 mg daily. Begin dosing at 75 mg two times a day an increase to 150 mg two times daily after one week if response is inadequate. May increase to 300 mg twice daily if response is inadequate after 2 to 3 weeks.
  • Treating seizures: The recommended dose for treating seizures is 150-600 mg/day divided into 2 or 3 doses, starting at 150 mg daily and increasing based on response and tolerability. The maximum dose is 600 mg/day.
  • Treating fibromyalgia: Fibromyalgia is treated with 300-450 mg/day in 2 or 3 divided doses.

Hydrocodone

  • The initial dose for adults is 10 mg orally every 12 hours.
  • The dose may be increased every 3 to 7 days by 10 mg every 12 hours as needed to control pain.
  • Capsules must be swallowed whole and not chewed.

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What drugs interact with Lyrica and hydrocodone?

Lyrica

  • Alcohol and drugs that cause sedation may increase the sedative effects of pregabalin.
  • Pioglitazone (Actos) and rosiglitazone (Avandia) cause weight gain, fluid retention, and possibly heart failure. Therefore, combining pregabalin with these drugs may increase the occurrence of weight gain and fluid retention.

Hydrocodone

  • Concomitant use with CYP3A4 inhibitors (or discontinuation of CYP3A4 inducers) can result in a fatal overdose of hydrocodone.
  • Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing for use in patients for whom alternative treatment options are inadequate; limit dosages and durations to the minimum required; and follow patients for signs and symptoms of respiratory depression and sedation

Can I use Lyrica or hydrocodone while pregnant or breastfeeding?

Lyrica

  • There are no adequate studies of Lyrica in pregnant women.
  • It is not known whether Lyrica is excreted in breast milk.

Hydrocodone

  • There are no adequate studies of hydrocodone in pregnant women.
  • Hydrocodone is excreted in breast milk, and, therefore should be used cautiously by nursing mothers.

Medically Reviewed on 12/18/2018

References

REFERENCE:

FDA Prescribing Information