Prerica contains pregabalin, a prescription medicine used for nerve pain, as an add-on treatment for epilepsy, and for generalised anxiety disorder. It comes as capsules from 25 mg to 150 mg. It is a Schedule 5 medicine with a recognised potential for dependence, and it should not be started or stopped abruptly on your own.
What is Prerica?
Prerica contains pregabalin and is registered in South Africa as Schedule 5 capsules:
| Product | Strength |
|---|---|
| Prerica 25 mg | Pregabalin 25 mg |
| Prerica 50 mg | Pregabalin 50 mg |
| Prerica 75 mg | Pregabalin 75 mg |
| Prerica 100 mg | Pregabalin 100 mg |
| Prerica 150 mg | Pregabalin 150 mg |
Schedule 5 means prescription-only, with additional controls. The wide range of strengths exists because pregabalin is normally started low and increased gradually until it helps — the strength you are given says more about where you are in that process than about how severe your condition is.
Pregabalin is often described as an anti-epileptic, and that is where the class originated, but its structure resembles the neurotransmitter GABA without actually acting on GABA receptors. It binds to a subunit of calcium channels on overactive nerve endings and reduces the release of excitatory signalling chemicals. In plain terms, it turns down nerves that are firing too readily.
That single mechanism explains its three quite different uses: nerve pain comes from damaged nerves signalling pain without cause, seizures come from runaway electrical activity, and anxiety involves overactive signalling in circuits that regulate arousal.
Pregabalin is not a painkiller in the ordinary sense. It does nothing for a headache, a sprain or inflammatory pain. It works on pain generated by the nervous system itself, which is why it can help conditions that do not respond to anti-inflammatories at all.
What is Prerica commonly used for?
- Neuropathic (nerve) pain — the main use. This includes diabetic nerve pain, pain after shingles, nerve pain from injury, and some spinal and sciatic pain. It is typically described as burning, shooting, electric or accompanied by numbness and pins and needles.
- Fibromyalgia, for widespread pain and associated sleep disturbance.
- Epilepsy, as an add-on to other treatment for partial seizures — not usually alone.
- Generalised anxiety disorder, where it is an option when other treatments are unsuitable.
It usually takes time to work. People often notice benefit within one to two weeks, but the dose is normally built up gradually and a fair trial takes longer. It is not a medicine to judge after two days.
It is not a treatment for the underlying nerve damage. In diabetic nerve pain, for example, it reduces the pain while blood sugar control remains the thing that protects the nerves.
How Prerica fits into this medicine category
| Group | Examples | Typical role |
|---|---|---|
| Gabapentinoids | Pregabalin (Prerica), gabapentin | Nerve pain, add-on epilepsy, anxiety |
| Tricyclics | Amitriptyline | Nerve pain, low mood, sleep |
| SSRIs / SNRIs | Fluoxetine, duloxetine | Depression, anxiety; duloxetine also nerve pain |
| Benzodiazepines | Diazepam, clonazepam | Short-term anxiety, muscle spasm, some seizures |
| Anti-epileptics | Sodium valproate, carbamazepine | Seizure control; some nerve pain |
| Opioids | Tramadol, morphine | Moderate to severe pain of other kinds |
Nerve pain is usually treated with medicines from this list rather than with ordinary painkillers, because anti-inflammatories and paracetamol work poorly on it. See the mental health, nerve and neurological medicines hub.
What to check before using Prerica
Do not start or stop it abruptly. Pregabalin is normally introduced gradually and, when stopped, reduced over at least a week — often longer. Stopping suddenly can cause insomnia, headache, nausea, anxiety, sweating and, in people using it for epilepsy, an increased risk of seizures.
Tell your doctor or pharmacist if you:
- Have kidney disease. This is the single most important check — pregabalin is cleared almost entirely by the kidneys, and the amount must be reduced if they are impaired. Doses appropriate for normal kidneys can accumulate to harmful levels otherwise.
- Take opioid painkillers such as tramadol, codeine or morphine. The combination can cause serious respiratory depression, and this has caused deaths. It is sometimes prescribed deliberately, but must be known about and monitored.
- Take any other sedating medicine, including benzodiazepines, sleeping tablets, sedating antihistamines or muscle relaxants.
- Drink alcohol, which adds to the sedation.
- Have heart failure. Pregabalin can cause fluid retention.
- Have a history of substance misuse or dependence.
- Have breathing problems, such as COPD or sleep apnoea.
- Have depression or a history of suicidal thoughts.
- Are pregnant, planning pregnancy, or breastfeeding.
- Are diabetic — weight gain on pregabalin may require blood sugar treatment to be reviewed.
Do not drive or operate machinery until you know how it affects you. Dizziness and drowsiness are common, especially in the first weeks and after any increase.
Possible cautions and when to ask a pharmacist or doctor
The most common effects are dizziness, drowsiness, weight gain, dry mouth, blurred vision, swelling of the hands or feet, difficulty concentrating and unsteadiness. Dizziness and sleepiness often ease after the first weeks.
Seek medical advice promptly if you experience:
- Slow or shallow breathing, or unusual difficulty waking — particularly if you also take an opioid or another sedative. Treat this as an emergency.
- New or worsening depression, or thoughts of self-harm or suicide. Anti-epileptic medicines carry a small increased risk, and it should be acted on rather than waited out.
- Swelling of the face, lips or tongue, or difficulty breathing.
- A spreading rash, blistering or peeling skin.
- Marked swelling of the legs, or breathlessness, which may indicate fluid retention.
- Confusion, hallucinations or marked unsteadiness, especially in older people, where falls are a real risk.
- Muscle pain or weakness with feeling unwell.
- Problems passing urine.
Pregabalin has a recognised potential for misuse and dependence, particularly at higher doses and in people with a history of substance misuse. Taking more than prescribed, running out early, or feeling unable to manage without it are reasons to speak to your doctor honestly rather than adjust the dose yourself. This is a medical issue, not a moral one, and it is far more manageable when raised early.
Contact your doctor if the medicine is not helping after a fair trial, if side effects are limiting, or if your circumstances change — particularly your kidney function.
Related medicine guides
- Browse Mental Health, Nerve & Neurological Medicines guides
- Read: Trepiline used for
- Read: Nurika used for
Frequently asked questions
What is Prerica used for? Nerve pain, fibromyalgia, epilepsy as an add-on treatment, and generalised anxiety disorder. It contains pregabalin and is prescription-only.
What is Prerica 25 mg used for? The lowest strength, usually a starting dose or a step in building up gradually. The strength reflects where you are in that process.
What is Prerica 75 mg used for? The same conditions at a higher dose, typically reached after starting lower. Your doctor sets the amount.
Is Prerica a painkiller? Not an ordinary one. It works on pain caused by the nervous system, not on inflammatory pain, and does nothing for a headache or a sprain.
Is Prerica addictive? It has a recognised potential for dependence and misuse, which is why it is Schedule 5. Take it as prescribed and tell your doctor if you feel you need more.
Can I stop taking it if I feel better? Not abruptly. It should be reduced gradually under medical guidance, or withdrawal symptoms — and, in epilepsy, seizures — can follow.
Can I drink alcohol with it? Alcohol adds to drowsiness and dizziness. Discuss it with your doctor; avoiding it is safest.
Does it cause weight gain? Weight gain and fluid retention are recognised effects. Mention it to your doctor if it becomes a problem.