What the FDA labels say about taking them together
Hydromorphone and pregabalin
Hydromorphone's FDA label of May 14, 2026 names pregabalin in its drug interactions section; pregabalin's label does not name hydromorphone itself but warns about its class (Opioids (opioid agonists)). The hydromorphone label: “Due to additive pharmacologic effect, the concomitant use of benzodiazepines or other CNS depressants, including alcohol, can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death.”
Check it at the source: the hydromorphone FDA label on DailyMed (effective May 14, 2026, Rhodes Pharmaceuticals LLC); the pregabalin FDA label on DailyMed (effective April 15, 2025, Viatris Specialty LLC).
What does the hydromorphone label say about pregabalin?
Hydromorphone label, drug interactionsBenzodiazepines and other Central Nervous System (CNS) Depressants Clinical Impact: Due to additive pharmacologic effect, the concomitant use of benzodiazepines or other CNS depressants, including alcohol, can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death. … anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics, gabapentinoids (gabapentin or pregabalin), other opioids, alcohol.
Hydromorphone label, warnings and precautionsRisks from Concomitant Use with Benzodiazepines or Other CNS Depressants Profound sedation, respiratory depression, coma, and death may result from the concomitant use of hydromorphone hydrochloride oral solution and hydromorphone hydrochloride tablets with benzodiazepines and/or other CNS depressants, including alcohol (e.g., non-benzodiazepine sedatives/hypnotics, anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics, gabapentinoids [gabapentin or pregabalin], and other opioids).
Hydromorphone Hydrochloride label (Fresenius Kabi USA, LLC, July 15, 2026), drug interactionsBenzodiazepines and other Central Nervous System Depressants (CNS) Clinical Impact: Due to additive pharmacologic effect, the concomitant use of benzodiazepines and other CNS depressants, including alcohol, can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death. … anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics, gabapentinoids (gabapentin or pregabalin), other opioids, alcohol.
Hydromorphone Hydrochloride label (Fresenius Kabi USA, LLC, July 15, 2026), warnings and precautionsRisks from Concomitant Use with Benzodiazepines or Other CNS Depressants Profound sedation, respiratory depression, coma, and death may result from the concomitant use of Hydromorphone Hydrochloride Injection or Hydromorphone Hydrochloride Injection [high potency formulation (HPF)] with benzodiazepines and/or other CNS depressants, including alcohol (e.g., non-benzodiazepine sedatives/hypnotics, anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics, gabapentinoids [gabapentin or pregabalin], and other opioids).
Source: FDA drug label (Hydromorphone Hydrochloride, NDA019034), Fresenius Kabi USA, LLC, effective July 15, 2026 (SPL set e034eb96-03e0-46e1-8b92-5e1f94555e7b), via openFDA
Source: FDA drug label (Hydromorphone Hydrochloride), Rhodes Pharmaceuticals LLC, effective May 14, 2026 (SPL set 37565441-0d95-4743-a695-d7b3326f58a1), via openFDA; the full label on DailyMed
What does the pregabalin label say about hydromorphone?
Pregabalin's label does not name hydromorphone itself; it warns about its class (Opioids (opioid agonists)):
Pregabalin label, warnings and precautionsThere is evidence from case reports, human studies, and animal studies associating LYRICA with serious, life-threatening, or fatal respiratory depression when co-administered with central nervous system (CNS) depressants, including opioids, or in the setting of underlying respiratory impairment.
Pregabalin label, warnings and precautionsWhen the decision is made to co-prescribe LYRICA with another CNS depressant, particularly an opioid, or to prescribe LYRICA to patients with underlying respiratory impairment, monitor patients for symptoms of respiratory depression and sedation, and consider initiating LYRICA at a low dose.
Source: FDA drug label (Lyrica), NDA021446 (Upjohn), as published by Viatris Specialty LLC, effective April 15, 2025 (SPL set d4734e7d-5079-455e-8ff5-8f4539c998a9), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Hydromorphone | Pregabalin | |
|---|---|---|
| Labeled for | Pain | Nerve pain and fibromyalgia, Seizures and epilepsy |
| Boxed warning | Yes | No |
| Pharmacy cost (NADAC) | $0.219 per tablet 4 mg tablet | $0.0571 per capsule 100 mg capsule |
| Shortage now | In shortage | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once