Pregabalin comes in more strengths than most medicines — 25, 50, 75, 100, 150, 200, 225, 300 mg in many countries, plus 450 mg in India. We stock the four that cover the great majority of prescriptions. Here is how they relate, in general terms; your own dose is set by your prescriber.
75 mg — the usual start
Most people begin on 75 mg twice a day (150 mg daily). Starting low gives the body time to adjust to the drowsiness, dizziness and "foggy" feeling that are common in the first week or two and then usually fade. Some stay here, especially for anxiety or milder nerve pain.
150 mg — the common maintenance dose
After a week or so, if 75 mg isn't enough, the dose is often doubled to 150 mg twice daily (300 mg a day). This is the dose most of the large trials in diabetic nerve pain and post-shingles pain were run at, and it's where a lot of people settle long-term.
300 mg — the upper maintenance dose
300 mg twice daily (600 mg a day) is the maximum licensed dose for neuropathic pain and anxiety. A single 300 mg capsule replaces two 150s, which is convenient for anyone already at that level. Doctors usually reach it only after at least a week on 150 mg, and only when the lower dose clearly helps but not enough.
450 mg — the high-strength single capsule
450 mg capsules exist mainly for fibromyalgia, where 450 mg a day is a studied dose, and for people on high daily totals who want one capsule instead of two. This strength is uncommon outside India and should only be used by people already established on high-dose pregabalin with their prescriber's agreement. It is not a starting dose.
Stepping down matters as much as stepping up
Pregabalin shouldn't be stopped suddenly. Coming off it over at least a week — longer after high doses — avoids withdrawal symptoms such as insomnia, headache, nausea, sweating and anxiety. This is true at every strength, including 75 mg.
Why the price per capsule rises with strength
Our prices are $1 (75 mg), $2 (150 mg), $2.50 (300 mg) and $3 (450 mg) per capsule, the same at every pack size. The jump from 75 to 150 reflects the raw material; the smaller steps above that reflect that a 300 mg capsule is cheaper to make than two 150s. If your daily dose is 300 mg, one 300 mg capsule a day ($2.50) is cheaper than two 150s ($4), so match the capsule to your prescription rather than splitting doses.
75 mg · 150 mg · 300 mg · 450 mg
General information only; not a substitute for your prescriber's instructions.