Tapering Off Pregabalin

Recommended Tapering Schedule

For patients on 100 mg three times daily (300 mg/day total), a tapering schedule of reducing to 75 mg three times daily (225 mg/day) in the first week is recommended, as suggested by the Mayo Clinic Proceedings 1
Reducing to 50 mg three times daily (150 mg/day) in the second week is recommended, as suggested by the Mayo Clinic Proceedings 1
Reducing to 25 mg three times daily (75 mg/day) in the third week is recommended, as suggested by the Mayo Clinic Proceedings 1

Elderly patients or those with renal impairment may require more gradual tapering, according to the American Geriatrics Society 2

Monitoring for withdrawal symptoms such as headache, nausea, and dizziness is recommended during the tapering process, as suggested by the Mayo Clinic Proceedings and the American Geriatrics Society 1, 2
Watching for return or worsening of pain during the tapering process is also recommended, according to the American Geriatrics Society 2

If withdrawal symptoms occur during tapering, considering slowing the taper by extending each step to 2 weeks instead of 1 week is recommended, as suggested by the Mayo Clinic Proceedings 1

A one-size-fits-all approach should be avoided, as some patients may require a more individualized tapering schedule based on their clinical response, according to the American Geriatrics Society 2

The Mayo Clinic recommends monitoring for falls risk throughout the taper period, as elderly patients are particularly vulnerable to dizziness, confusion, and balance disturbances during dose changes 3

Elderly patients should extend the taper to 4-8 weeks, as they are at higher risk of withdrawal symptoms, falls, confusion, and sedation, according to the FDA guidelines, although the FDA mandates a minimum of 1 week 3