By Lauren Smith
Updated: 21 April 2023 & medically reviewed by Dr. Jenni Jacobsen
Lyrica, the brand name for the anticonvulsant and neuropathic pain medication pregabalin, is increasingly abused to augment the highs of opioids and may be detected in specialized drug testing. With a short elimination half-life, Lyrica only remains in the bloodstream for one to two days but can be detected in the urine for up to five or six days.
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Lyrica (pregabalin) has a relatively short elimination half-life of between 5.5 and 6.7 hours in patients with normal renal function. The half-life doesn’t change with dose level or repeated administration.
A medication's half-life is the amount of time it takes for half of the drug to be eliminated from your bloodstream.
Pregabalin's half-life is short compared to many other common medications and therefore the drug is usually administered two to three times a day so patients maintain an adequate therapeutic dose.
How long does Lyrica stay in your system?
It usually takes five to six half-lives for most of a drug to be eliminated from your bloodstream, so Lyrica will be largely gone from your blood within 27.5 to 40.2 hours.
However, Lyrica may remain and be detectable in your urine, saliva, and hair for substantially longer than it stays in your bloodstream. For example, in a study, urine samples remained positive for pregabalin for 56 hours after the ingestion of 75mg and for 64 hours after the ingestion of 150mg.
How long does Lyrica take to work?
People who take Lyrica as prescribed ingest the capsules, which make their way to the digestive system where they’re absorbed. Peak concentrations of pregabalin in the bloodstream are reached 0.7 to 1.3 hours (42 to 78 minutes) after ingestion. Taking pregabalin with a meal reduces the absorption rate, but not the extent, and leads to a delay in peak concentration and effects.
At clinical doses, Lyrica doesn’t have much immediate effect: at most, patients who haven't used it before might feel sleepy or dizzy. The therapeutic effects of Lyrica don't emerge until you’ve regularly taken it for at least two days. Sometimes, it may take two to four weeks for Lyrica to relieve neuropathic pain.
People who abuse pregabalin may employ other administration methods to get the drug into their bloodstreams more quickly and achieve a more intense high. They may break open the capsules and snort the powder inside. More rarely they may take it sublingually, intravenously, rectally, or smoke it.
Recreational doses of pregabalin are much higher than clinical doses—typically by a magnitude of between three to 20—and do produce noticeable acute effects, including a feeling of relaxation and euphoria often compared to tipsiness.
Does Lyrica show up in drug tests?
Lyrica is a prescription drug and won’t be detected on standard drug tests administered by employers because it’s not a typical drug of abuse and is only classified as a Schedule V substance. However, it can be detected by specialized tests, which may be administered by medical professionals, staff at rehab facilities, or law enforcement if they suspect pregabalin abuse.
Pregabalin is eliminated by the kidneys into the urine in a largely unchanged form. Specialized urine test strips are available commercially and can detect pregabalin for two to four days after use. More sensitive testing may detect pregabalin traces in urine for, at most, five to six days.
Blood drug testing is less common because it's invasive, and the detection windows are shorter. However, blood testing may be employed in medical settings, such as if a patient presents with a suspected overdose. Based on pregabalin’s elimination half-life of around six hours, it might be found in blood samples for one to two days after the last use.
Saliva testing for pregabalin is uncommon but has been performed, with studies suggesting saliva concentrations correlate to blood plasma concentrations. This suggests pregabalin would be detectable in saliva for one to two days after use.
Pregabalin circulating in the body will be incorporated into hair strands as they grow and can be detected if strands are plucked and analyzed. In a standard hair follicle test, the top 1.5 inches of head hair is examined. Because head hair grows at an average rate of 0.5 inches per month, that means evidence of your drug use for the previous three months can be found.
What affects how long Lyrica stays in your system?
Everyone processes drugs slightly differently, and the length of time Lyrica remains in and is detectable in your system may vary, with influence from the following factors:
Kidney function: Pregabalin is excreted by the kidneys into the urine, so impaired kidney function means the drug will stay in your body for longer. In studies of patients with impaired renal function, the elimination half-life of pregabalin was extended to up to 52 hours.
Age: Older adults are known to eliminate drugs more slowly, which may prolong the length of time pregabalin remains in their system.
What you’ve eaten: When pregabalin is orally ingested with a meal, food reduces the rate of absorption, but not the extent, and leads to a lower and delayed peak blood concentration.
Unlike some drugs, Lyrica has linear, predictable pharmacokinetics, which means its elimination is unaffected by the dose you take.
Related: Does pregabalin cause weight gain?
Can you overdose on Lyrica?
People who abuse pregabalin frequently take very high doses to magnify the drug’s euphoric effects, leaving them at risk of overdose. Between 2014 and 2019, most (70%) pregabalin overdoses requiring hospital treatment involve deliberate self-poisonings, but recreational overdoses are on the rise. They accounted for just 4% of pregabalin overdoses in 2014 but had risen to 39% by 2019.
Overdoses on pregabalin alone don’t cause severe toxicity. The most common symptoms are sedation and, rarely (in 5% of cases), seizures.
However, in most cases requiring hospitalization, pregabalin has been consumed with another substance, usually opioids or benzodiazepines. These drugs’ depression of the central nervous system (CNS) can compound pregabalin’s sedating effects and make overdoses more dangerous. One study found that pregabalin and the related gabapentin could potentially increase the risk and severity of opioid overdose by further depressing respiration.