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Thread: Any studies showing 600mg Lyrica more effective than 300mg?

  1. #1

    Any studies showing 600mg Lyrica more effective than 300mg?

    I believe that the maximum dose is 600 mg daily. However, my doctor believes that there is no evidence to support more than 300 mg daily. Has anyone seen studies to show that 600 mg daily can be more effective than 300?

    Thank you for any feedback.
    Jason

    C5/6 Complete - water skiing accident 1994.

  2. #2
    Quote Originally Posted by jeft View Post
    I believe that the maximum dose is 600 mg daily. However, my doctor believes that there is no evidence to support more than 300 mg daily. Has anyone seen studies to show that 600 mg daily can be more effective than 300?

    Thank you for any feedback.
    Is it a PCP?

    Pregabalin (Lyrica) dose is limited to a max of 300 mg daily for diabetic neuropathy (which a primary care doc would likely be much more familiar with).

    It is FDA approved for up to 600 mg daily in neuropathic paid due to spinal cord injury, and after a brief investigation I couldn't find any studies suggesting no improvement in pain with an increase from 300 mg to 600 mg. If he's a PCP, I'd almost bet he's thinking of studies involving diabetic patients. I would just kindly suggest to him that your pain is not well controlled and you'd like to 'try' a higher dose of lyrica since doses higher than 300 have been well studied and are generally well tolerated.

    https://www.ncbi.nlm.nih.gov/pubmed/17130411 - in this SCI specific study the AVERAGE dose was 460 mg/day which means more than half of them were on doses higher than 300 mg/day since 600 was the max.

  3. #3
    Thanks for the great info funklab. He is a pain specialist but is under the impression that exceeding 300 is only appropriate for fibromyalgia. It's always fun trying to respectfully introduce information. I'll share this with him.

    I found this link as well https://www.drugs.com/pro/lyrica.html#S14.5
    Jason

    C5/6 Complete - water skiing accident 1994.

  4. #4
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    My PMNR Doc gave me a script for 600 mg/day while I was having a horrible couple of weeks. I've stayed at 300 mg/day for now, but she's the best SCI doc in town so I'd say 600 is OK.
    T3-T7 complete since Sept 2015

  5. #5
    Quote Originally Posted by jeft View Post
    Thanks for the great info funklab. He is a pain specialist but is under the impression that exceeding 300 is only appropriate for fibromyalgia. It's always fun trying to respectfully introduce information. I'll share this with him.

    I found this link as well https://www.drugs.com/pro/lyrica.html#S14.5
    It's absolutely appropriate, FDA approved for your specific indication and commonly prescribed. He may know of some study showing that 600 is no better than 300, but I couldn't find anyhting after a brief search, and it certainly seems people are being prescribed 600 for SCI pain.

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