Drug interactions
Pregabalin + Zuranolone
Severity: Major
Pregabalin and Zuranolone: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Zuranolone causes significant somnolence and impairs driving ability, and pregabalin adds further sedating effects. Combined use can increase impairment of psychomotor performance and CNS depression.
What this interaction means in plain words
Pregabalin and Zuranolone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Pregabalin belongs to Central Nervous System; Zuranolone belongs to Central Nervous System.
Why it happens
Additive central nervous system depression; zuranolone is a positive GABA-A modulator while pregabalin reduces excitatory neurotransmission.
What to do
Consider reducing the zuranolone dose if sedation occurs, and review the need for pregabalin. Advise against driving or hazardous activities for at least 12 hours after each zuranolone dose.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Alzain 100 mg Capsules, Hard - SmPC sections 4.3/4.5 (class statement: other central nervous system (CNS) depressant medicinal products; "there are reports of respiratory failure, coma and deaths in patients taking pregabalin and opioids and/or other central nervous system (CNS) depressant medicin") — electronic medicines compendium (UK SmPC)
Other interactions of Pregabalin
Other interactions of Zuranolone
- Alprazolam + Zuranolone Major
- Amobarbital + Zuranolone Major
- Apalutamide + Zuranolone Major
- Asenapine + Zuranolone Major
- Brexpiprazole + Zuranolone Major
- Butorphanol + Zuranolone Major
Frequently asked questions
Can I take Pregabalin with Zuranolone?
MediHelp rates the interaction as major. Pregabalin and Zuranolone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Zuranolone causes significant somnolence and impairs driving ability, and pregabalin adds further sedating effects. Combined use can increase impairment of psychomotor performance and CNS depression.
How serious is the interaction between Pregabalin and Zuranolone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider reducing the zuranolone dose if sedation occurs, and review the need for pregabalin. Advise against driving or hazardous activities for at least 12 hours after each zuranolone dose.
What other medicines interact with Pregabalin?
MediHelp also lists interactions of Pregabalin with, for example, Alprazolam, Amobarbital, Belladonna and opium. The full list is on the Pregabalin page.
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