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Brand names: Lyrica • Drug class: Gabapentinoid (anticonvulsant)
Pregabalin is used for nerve pain, fibromyalgia, and restless legs — and like gabapentin, it is cleared entirely by the kidneys. Unadjusted dosing in CKD causes severe sedation, dizziness, and falls; the label provides CrCl-based dose tables.
Pregabalin is excreted unchanged by the kidney — 100% renal clearance. In CKD and dialysis, levels rise several-fold without adjustment. FDA label: reduce dose for CrCl <60; dialysis patients take a dose after each session. It's also used at low doses for uremic pruritus and restless legs in dialysis patients.
Label renal dosing: CrCl 30-60 → 75-300 mg/day; 15-30 → 25-150 mg/day; <15 → 25-75 mg/day
FDA Lyrica prescribing information, 2024
Higher sedation and fall risk at unadjusted doses in CKD
Pharmacovigilance data, 2022
Start at the lowest dose in CKD and titrate slowly. Dialysis: 25-75 mg after each session. CrCl 30-60: max 300 mg/day; CrCl 15-30: max 150 mg/day; CrCl <15: max 75 mg/day.
Check your kidney functionThis page is educational. Medication decisions — especially dosing changes — must be made by your prescribing clinician.
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