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Curr Med Res Opin. 2018 Apr;34(4):677-682. doi: 10.1080/03007995.2017.1391756. Epub 2017 Dec 4.

Is there a role for combined use of gabapentin and pregabalin in pain control? Too good to be true?

Author information

a University of Toronto , Department of Family and Community Medicine, Division of Palliative Care , Toronto , Ontario , Canada.
b Baycrest Health Sciences , Toronto , Ontario , Canada.


Gabapentin (Neurontin 1 ) and pregabalin (Lyrica 2 ) are first- and second-generation α2δ ligands, respectively, and are both approved for use as adjunctive therapy in pain control. Although they do not bind to gamma-aminobutyric acid (GABA) receptors they have been successfully used to treat neuropathic pain conditions. Their mechanism of action is not yet fully understood, but research has demonstrated promising results. Despite their similarities, they have been used in combination in both clinical and research situations, and have been noted to have a synergistic effect in pain control without concern for clinically significant pharmacokinetic interactions. This combined approach can be made use of to reduce the dose of an individual agent, its side effects, and to enhance therapeutic response compared to a single agent. Pharmacokinetics, drug interactions, and adverse reaction to combinations have to be taken into consideration before combination therapy with gabapentin and pregabalin is proposed as first-line treatment in refractory pain situations and in patients with low levels of tolerance for an individual agent.


Gabapentin; combination therapy; neuropathic pain; pain modulation; pregabalin

[Indexed for MEDLINE]

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