Dangers of Mixing Pregabalin and Alcohol

If you take pregabalin and you’ve been wondering whether it’s safe to have a drink alongside it, you’re asking a question that a lot of people on this medication think about. Pregabalin is one of the most widely prescribed drugs in the UK, and for many of the people taking it, alcohol is a normal part of their social life.

This guide explains what pregabalin does, why alcohol interacts with it the way it does and where the real risks sit so you can make an informed decision about your own situation.

What pregabalin is and how it works

Pregabalin is a prescription medication sold under brand names like Lyrica and Alzain. The NHS describes it as a medicine used to treat epilepsy and generalised anxiety disorder. It’s also prescribed for nerve pain caused by conditions like diabetes and shingles.

It works by binding to calcium channels in the nervous system, which reduces the release of chemicals that carry excitatory signals between nerve cells. This calms down overactive electrical activity in the brain. That means fewer seizures in epilepsy and in anxiety, the brain releases fewer of the chemicals that produce anxious feelings.

The reason this matters for the alcohol question is that pregabalin is a central nervous system depressant, and it slows things down by design. Alcohol does the same thing through a different mechanism, and when both are in your system at the same time, those sedative effects compound each other.

Pregabalin was reclassified as a Class C controlled substance in the UK in 2019, and the MHRA made the decision in response to rising rates of misuse and dependence. The update noted that pregabalin can depress the central nervous system and that the risk of fatal respiratory depression increases when it’s used alongside opioid medicines or alcohol.

Why mixing pregabalin and alcohol is dangerous

The EMC Summary of Product Characteristics for pregabalin states that it “may potentiate the effects of ethanol.” This means that even a moderate amount of alcohol can produce unwanted and in some cases, dangerous side effects.

Below, we explore some of these side effects and why they could happen to you if you mix both pregabalin and alcohol.

Who is most at risk of experiencing dangerous side effects when mixing pregabalin and alcohol?

The combination of pregabalin and alcohol affects different people differently, and certain groups face a higher level of danger.

The MHRA’s 2021 Drug Safety Update identifies several higher-risk groups for severe respiratory depression on pregabalin.

These include people with compromised respiratory function, such as COPD or sleep apnoea and people with neurological conditions. People with reduced kidney function are also at higher risk because pregabalin is cleared almost entirely by the kidneys and accumulates if they aren’t working properly.

People over 65 face an increased risk because both pregabalin and alcohol are metabolised more slowly with age, meaning the sedative effects last longer and build up more easily.

Anyone on a higher pregabalin dose, particularly above 300mg per day, should be especially cautious, as combining this with alcohol raises the risk of opioid-related death.

Anyone already taking another CNS depressant alongside pregabalin is adding alcohol as a third depressant to a system that is already under significant sedative load. This applies to opioid painkillers and benzodiazepines in particular.

People with a history of substance misuse face a dual risk. Pregabalin has documented dependence potential, and the MHRA received 113 reports of abuse and 98 reports of dependence with pregabalin prior to the 2019 reclassification.4

Combining it with alcohol increases both the immediate physical harm and the risk of developing dependence on either substance.

If you fall into any of the categories mentioned above and your prescriber hasn’t explained these possible complications, it’s worth booking another session with them. Once you’re able to fully understand the risks, the chances of something going wrong reduce.

What it might mean if you’re finding it hard to avoid alcohol

Most people reading this page will be here because they take pregabalin for a genuine medical reason and want to know whether they can have a drink. The safest course is to avoid alcohol while taking pregabalin, which is the position stated in the patient information leaflet that comes with every UK pregabalin pack.

Reading that advice and feeling frustrated because going without alcohol feels difficult is something worth sitting with for a moment. Struggling to set aside drinking while you’re on a medication that interacts with it can be an early indicator that your relationship with alcohol has changed.

You don’t need to have a definitive answer to that question right now, and this page isn’t here to diagnose anything. But if the idea of not drinking while on pregabalin feels genuinely hard rather than mildly inconvenient, speaking to someone about it is a reasonable next step.

How UKAT can help

If anything on this page has raised questions about your drinking, UKAT can help you make sense of where things stand. Our team understands that recognising a problem with alcoholism is rarely straightforward and that most people don’t arrive at that conclusion overnight.

UKAT provides residential addiction treatment across the UK, with comprehensive alcohol treatment programmes and prescription drug treatment programmes that includes detox and therapy, with aftercare planning built in. Our clinical team can work with you and your prescriber to make sure both issues are addressed safely if pregabalin and alcohol are both part of the picture.

Contact UKAT today for advice on your next steps.