Two medicines, side by side
Carbamazepine vs pregabalin
Carbamazepine and pregabalin are both labeled for seizures and epilepsy. Drugs@FDA records approvals of carbamazepine since 1968 and of pregabalin since 2004. Pharmacies paid $0.119 per carbamazepine 200 mg tablet and $0.0571 per pregabalin 100 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Only the carbamazepine label carries a boxed warning.
Check it at the source: the carbamazepine FDA label on DailyMed (effective August 20, 2026); the pregabalin FDA label on DailyMed (effective April 15, 2025).
Highlights of the carbamazepine record
Carbamazepine (Tegretol) · label of August 20, 2026
SERIOUS DERMATOLOGIC REACTIONS AND HLA-B*1502 ALLELE SERIOUS AND SOMETIMES FATAL DERMATOLOGIC REACTIONS, INCLUDING TOXIC EPIDERMAL NECROLYSIS (TEN) AND STEVENS-JOHNSON SYNDROME (SJS), HAVE BEEN REPORTED DURING TREATMENT WITH TEGRETOL. THESE REACTIONS ARE ESTIMATED TO OCCUR IN 1 TO 6 PER 10,000 NEW USERS IN COUNTRIES WITH MAINLY CAUCASIAN POPULATIONS, BUT THE RISK IN SOME ASIAN COUNTRIES IS ESTIMATED TO BE ABOUT 10 TIMES HIGHER.
Used for
From the label: indicationsEpilepsy Tegretol is indicated for use as an anticonvulsant drug. Evidence supporting efficacy of Tegretol as an anticonvulsant was derived from active drug-controlled studies that enrolled patients with the following seizure types: Partial seizures with complex symptomatology (psychomotor, temporal lobe). Patients with these seizures appear to show greater improvement than those with other types. […]
On the market
- Earliest approval on file
- March 11, 1968
- Generic labelers
- 42 labelers
- Pharmacy cost
- $0.119 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 11
Highlights of the pregabalin record
Pregabalin (Lyrica) · label of April 15, 2025
Used for
From the label: indicationsLYRICA is indicated for: • Management of neuropathic pain associated with diabetic peripheral neuropathy • Management of postherpetic neuralgia • Adjunctive therapy for the treatment of partial‑onset seizures in patients 1 month of age and older • Management of fibromyalgia • Management of neuropathic pain associated with spinal cord injury LYRICA is indicated for: • Neuropathic pain associated with diabetic […]
On the market
- Earliest approval on file
- December 30, 2004
- Generic labelers
- 52 labelers
- Pharmacy cost
- $0.0571 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Carbamazepine label of August 20, 2026, Pregabalin label of April 15, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do carbamazepine and pregabalin differ on the record?
Only the carbamazepine label carries a boxed warning.
How each works, in its label's words: Carbamazepine, “It appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation.”; Pregabalin, “LYRICA (pregabalin) binds with high affinity to the alpha 2 -delta site (an auxiliary subunit of voltage-gated calcium channels) in central nervous system tissues.”
Half-life, in each label's words: Carbamazepine, “Initial half-life values range from 25 to 65 hours, decreasing to 12 to 17 hours on repeated doses.”; Pregabalin, “12.3 Pharmacokinetics Pregabalin is well absorbed after oral administration, is eliminated largely by renal excretion …”
Generics: carbamazepine since 1986; pregabalin since 2019 (Drugs@FDA).
DEA schedule: carbamazepine none; pregabalin CV.
| Carbamazepine | Pregabalin | |
|---|---|---|
| Labeled for | Bipolar disorder, Seizures and epilepsy | Nerve pain and fibromyalgia, Seizures and epilepsy |
| Pharmacologic class | Mood Stabilizer | n/a |
| How it works (label) | Mechanism of Action Tegretol has demonstrated anticonvulsant properties in rats and mice with electrically and chemically induced seizures. It appears to act by reducing polysynaptic responses and blocking the post-tetanic potentiation. | LYRICA (pregabalin) binds with high affinity to the alpha 2 -delta site (an auxiliary subunit of voltage-gated calcium channels) in central nervous system tissues. |
| Half-life (label) | Initial half-life values range from 25 to 65 hours, decreasing to 12 to 17 hours on repeated doses. | 12.3 Pharmacokinetics Pregabalin is well absorbed after oral administration, is eliminated largely by renal excretion, and has an elimination half-life of about 6 hours. |
| Earliest approval on file (Drugs@FDA) | March 11, 1968 | December 30, 2004 |
| First generic approved | August 14, 1986 | July 19, 2019 |
| Generic labelers (NDC) | 42 labelers | 52 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.119 per tablet (Carbamazepine 200 mg tablet) | $0.0571 per capsule (Pregabalin 100 mg capsule) |
| 12-month price change | +0.6% | -15% |
| Boxed warning | Yes | No |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 11 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 66,615 | 270,624 |
| DEA schedule | none | CV |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Pregabalin label, drug interactionsSpecifically, there are no pharmacokinetic interactions between pregabalin and the following antiepileptic drugs: carbamazepine, valproic acid, lamotrigine, phenytoin, phenobarbital, and topiramate.
Pregabalin label, drug interactionsNo pharmacokinetic interactions were observed between LYRICA and carbamazepine, gabapentin, lamotrigine, oral contraceptive, phenobarbital, phenytoin, topiramate, and valproic acid.
Source: FDA drug labels via openFDA
What next?
- Alternatives to carbamazepine
- every medicine labeled for the same conditions