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What Is the Difference between Pregabalin and Gabapentin?

By H. Lo
Updated Mar 03, 2024
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Pregabalin and gabapentin are both anticonvulsants used to treat epileptic seizures and a variety of other medical conditions. As medications that are very similar, they do have their differences. The main difference is that pregabalin is the more potent of the two medications. Other differences between the two medications are that the body absorbs pregabalin at a faster rate, and pregabalin also causes less dose-dependent side effects than gabapentin.

While both medications are used to treat epileptic seizures, they can be used to treat other conditions as well. Pregabalin, for example, is also used to treat neuropathic pain and fibromyalgia. In addition, gabapentin also treats postherpetic neuralgia (PHN) pan and restless legs syndrome (RLS). A patient’s medical condition, combined with the type of medication he or she takes, determines his or her treatment dosage.

Since pregabalin is more potent than gabapentin, it takes a smaller dose of pregabalin to equal the same level of potency in a dose of gabapentin. This means a patient would take a lesser dose of pregabalin as opposed to a bigger dose of gabapentin. The absorption properties of pregabalin also work to its advantage as it ensures a steadier intake of the medication. Pregabalin and gabapentin both cause side effects but gabapentin tends to cause more side effects that depend on the dosage of the medication. Of course, side effects also depend on a patient’s specific condition as well.

The similarity between the makeup of pregabalin and gabapentin means that the side effects of both medications are sometimes the same, although they might differ as well. Side effects of pregabalin, some of which might also pertain to gabapentin, include balance problems, dry mouth and tremors. More serious side effects include abnormal bleeding or bruising, muscle pain and vision problems. Blurred vision, dizziness and headache are examples of side effects of gabapentin. Serious side effects, on the other hand, include abnormal urination, increased seizures and rapid eye movement.

Most notably for children, pregabalin and gabapentin can cause changes in behavior, such as increased aggressiveness. In addition, children might also experience concentration or memory problems. For all patients, pregabalin and gabapentin might also cause suicidal thoughts. Whichever side effects a patient experiences, he or she should not stop taking the medication before talking to a doctor. Usually, the patient will have to gradually stop taking the medication so that he or she can reduce the chances of suffering withdrawal symptoms such as diarrhea, increased seizures and trouble sleeping.

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Discussion Comments
By anon1001175 — On Mar 19, 2019

I have taken both gabapentin and pregabalin and i had no side effocts with either one.

I was on gabapentin for about four years and it did me no favors so I was moved to pregabalin about five weeks ago and still it's a waste of time, If anything, I'm worse off; I'm not any better for it. No matter what I take, I just feel nothing works the only I have found is that I want to drink where my mouth is so dry.

I was on 75mg three times a day but that was a total waste of time so the doctor put me up to 100mg 4 times a day and still I'm not feeling any benefits from them, honestly I am very disappointed indeed. I can't stand with being worse off

There have been many many times when I have thought about self medicating to see if I get any joy, as nothing is working for me. I think it's because I have so many conditions and possibly many hidden conditions that no one knows about. I just feel that I'm getting worse

Since being on pregabalin I feel that it has damaged so much ,as I am now unable to do a lot of things that I was once doing, which involves a lot more sitting. Walking is an even bigger struggle, housework has become an even bigger struggle and so much more have become massive struggles in my life.

I hope we all can find some sort of medication that works for all in many ways.

By anon994578 — On Feb 20, 2016

I have taken pregabalin for pain and anxiety for four years. I had to reduce the dosage because the higher dose made me put on lots of weight and made my legs and stomach swell so I was left on a dose of 75mg twice a day, and I needed to have one that I could go higher on. I have just gone on to gabapentin so I can try it and have the higher dose, but if I get the swelling back, I will have to go back to the lower dose of pregabalin. Both of them have given me headaches to start with, but they do go. I will let you know how I get on with them if it's OK.

By anon994554 — On Feb 18, 2016

I'm on Gabapentin for nerve and pain damage. I've only tried pre gabs once and it was very strong, but I feel I must change to them because I'm getting to used to taking gabapentin. I've never had bruising, but my mood swings are terrible.

By caroljo57 — On Nov 18, 2013

I have taken both Gabapentin and Pregabalin for neuropathic pain in my legs and feet. After trying Pregabalin for quite a while the swelling in my feet and legs became too unbearable to continue. I had to go back to Gabapentin and my swelling went down soon after.

By anon342633 — On Jul 22, 2013

I'm on gabapentin take 3/300mg by every 6hrs, I have chronic nerve damage in my arm, and I get a pins and needles feeling in my hand. It's very uncomfortable and I've had it for a while I want to give pregabalin a try.

By bluedolphin — On Mar 27, 2013

@burcidi-- I've experienced more bruising and longer time for bruises to heal while on both of these medications. I think both pregabalin and gabapentin reduce platelet count in the blood which is responsible for the bruising.

I have friend who is on gabapentin as well but he hasn't had any side effects.

I don't think one of these drugs is superior to the other. Give pregabalin a try and use the one that works best for you. But you have to come off of both drugs very slowly like the article said or you will have unpleasant withdrawal effects.

By ZipLine — On Mar 26, 2013

@burcidi-- I was on gabapentin in the beginning for fibromyalgia. I also had terrible side effects and my doctor switched to pregabalin. Pregabalin is definitely much better but I have had to take a larger dose. Gabapentin is a stronger medication but not everyone can take it.

By burcidi — On Mar 26, 2013

I'm on gabapentin right now. It has relieved my pain for the most part but I'm experiencing a lot of side effects. Migraines and mood swings seem to be the major ones. I've also noticed that I bruise more easily than usual. I don't know if that has to do with gabapentin or the recent injury I had.

Is pregabalin better in terms of side effects? If gabapentin is working fairly well for pain, does this mean that pregabalin will not be enough?

Has anyone taken both of these medications and can compare them for me?

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