Two medicines, side by side
Pregabalin vs topiramate
Pregabalin and topiramate are both labeled for seizures and epilepsy. Drugs@FDA records approvals of pregabalin since 2004 and of topiramate since 1996. Pharmacies paid $0.0571 per pregabalin 100 mg capsule and $0.0567 per topiramate 100 mg tablet (NADAC, October 7, 2026).
Check it at the source: the pregabalin FDA label on DailyMed (effective April 15, 2025); the topiramate FDA label on DailyMed (effective June 1, 2026).
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
Highlights of the topiramate record
Topiramate (Topamax) · label of June 1, 2026
Used for
From the label: indicationsTopiramate is indicated for: Epilepsy: initial monotherapy for the treatment of partial-onset or primary generalized tonic-clonic seizures in patients 2 years of age and older (1.1); adjunctive therapy for the treatment of partial-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox- Gastaut syndrome in patients 2 years of age and older (1.2) Preventive treatment of migraine […]
On the market
- Earliest approval on file
- December 24, 1996
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.0567 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 10
Source: FDA drug labels via openFDA (Pregabalin label of April 15, 2025, Topiramate label of June 1, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do pregabalin and topiramate differ on the record?
How each works, in its label's words: 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.”; Topiramate, “The precise mechanisms by which topiramate exerts its anticonvulsant and preventive migraine effects are unknown; however, preclinical studies have revealed four properties that may contribute to …”
Half-life, in each label's words: Pregabalin, “12.3 Pharmacokinetics Pregabalin is well absorbed after oral administration, is eliminated largely by renal excretion …”; Topiramate, “The mean plasma elimination half-life is 21 hours after single or multiple doses.”
Generics: pregabalin since 2019; topiramate since 2003 (Drugs@FDA).
DEA schedule: pregabalin CV; topiramate none.
| Pregabalin | Topiramate | |
|---|---|---|
| Labeled for | Nerve pain and fibromyalgia, Seizures and epilepsy | Seizures and epilepsy, Migraine |
| Pharmacologic class | n/a | n/a |
| How it works (label) | 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. | The precise mechanisms by which topiramate exerts its anticonvulsant and preventive migraine effects are unknown; however, preclinical studies have revealed four properties that may contribute to topiramate's efficacy for epilepsy and the … |
| Half-life (label) | 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. | The mean plasma elimination half-life is 21 hours after single or multiple doses. |
| Earliest approval on file (Drugs@FDA) | December 30, 2004 | December 24, 1996 |
| First generic approved | July 19, 2019 | December 17, 2003 |
| Generic labelers (NDC) | 52 labelers | 47 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0571 per capsule (Pregabalin 100 mg capsule) | $0.0567 per tablet (Topiramate 100 mg tablet) |
| 12-month price change | -15% | -10% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 5 | 10 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 270,624 | 91,067 |
| DEA schedule | CV | none |
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 do the labels say about using others of their kind?
Topiramate label, drug interactionsBecause of the potential of topiramate to cause CNS depression, as well as other cognitive and/or neuropsychiatric adverse reactions, topiramate should be used with extreme caution if used in combination with alcohol and other CNS depressants.
Source: FDA drug labels via openFDA
What next?
- Alternatives to pregabalin
- every medicine labeled for the same conditions