Two medicines, side by side
Duloxetine vs pregabalin
Duloxetine and pregabalin are both labeled for nerve pain and fibromyalgia. Drugs@FDA records approvals of duloxetine since 2004 and of pregabalin since 2004. Pharmacies paid $0.102 per duloxetine HCl DR 30 mg capsule 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 duloxetine label carries a boxed warning.
Check it at the source: the duloxetine FDA label on DailyMed (effective May 14, 2024); the pregabalin FDA label on DailyMed (effective April 15, 2025).
Highlights of the duloxetine record
Duloxetine (Cymbalta) · label of May 14, 2024
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions (5.1)]. WARNING: SUICIDAL THOUGHTS AND BEHAVIORS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsDRIZALMA SPRINKLE is indicated for the treatment of: • Major Depressive Disorder in adults • Generalized Anxiety Disorder in adults and pediatric patients 7 years of age and older • Diabetic Peripheral Neuropathy in adults • Fibromyalgia in adults • Chronic Musculoskeletal Pain in adults Additional pediatric use information is approved for Eli Lilly and Company, Inc.’s CYMBALTA (duloxetine delayed-release capsules). […]
On the market
- Earliest approval on file
- August 3, 2004
- Generic labelers
- 45 labelers
- Pharmacy cost
- $0.102 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 56
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 (Duloxetine label of May 14, 2024, Pregabalin label of April 15, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do duloxetine and pregabalin differ on the record?
Only the duloxetine label carries a boxed warning.
How each works, in its label's words: Duloxetine, “Although the exact mechanisms of the antidepressant, central pain inhibitory and anxiolytic actions of duloxetine in humans are unknown, these actions are believed to be related to its 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: Duloxetine, “Mean terminal half-life was 12.4 hours (range 7.8 to 22.2 hour) in subjects receiving a single dose DRIZALMA SPRINKLE.”; Pregabalin, “12.3 Pharmacokinetics Pregabalin is well absorbed after oral administration, is eliminated largely by renal excretion …”
Generics: duloxetine since 2013; pregabalin since 2019 (Drugs@FDA).
DEA schedule: duloxetine none; pregabalin CV.
| Duloxetine | Pregabalin | |
|---|---|---|
| Labeled for | Depression, Anxiety, Nerve pain and fibromyalgia, Pain | Nerve pain and fibromyalgia, Seizures and epilepsy |
| Pharmacologic class | Serotonin and Norepinephrine Reuptake Inhibitor | n/a |
| How it works (label) | Although the exact mechanisms of the antidepressant, central pain inhibitory and anxiolytic actions of duloxetine in humans are unknown, these actions are believed to be related to its potentiation of serotonergic and noradrenergic … | 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) | Mean terminal half-life was 12.4 hours (range 7.8 to 22.2 hour) in subjects receiving a single dose DRIZALMA SPRINKLE. | 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) | August 3, 2004 | December 30, 2004 |
| First generic approved | December 11, 2013 | July 19, 2019 |
| Generic labelers (NDC) | 45 labelers | 52 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.102 per capsule (Duloxetine HCl DR 30 mg capsule) | $0.0571 per capsule (Pregabalin 100 mg capsule) |
| 12-month price change | +31% | -15% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 56 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 69,298 | 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)
What do the labels say about using others of their kind?
Duloxetine label, drug interactionsExamples Selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, intravenous methylene blue Other Serotonergic Drugs Clinical Impact Concomitant use of duloxetine with other serotonergic drugs increases the risk of serotonin syndrome.
Source: FDA drug labels via openFDA
What next?
- Alternatives to duloxetine
- every medicine labeled for the same conditions