Can Lyrica cause hair loss? This is a question many patients taking pregabalin in the UK understandably ask. Lyrica (pregabalin) is widely prescribed for neuropathic pain, generalised anxiety disorder, and epilepsy — and the UK Summary of Product Characteristics (SmPC) does list alopecia as an uncommon recognised adverse effect. However, hair loss has many potential causes, from underlying health conditions to other medications, making clinical assessment essential. This article explains what the evidence says, how common this side effect is, and what steps to take if you notice changes in your hair whilst taking pregabalin.

Does Lyrica (Pregabalin) List Hair Loss as a Side Effect?

Yes — the UK Lyrica SmPC lists alopecia as an uncommon adverse effect, affecting between 1 in 1,000 and 1 in 100 patients. Always consult your GP before stopping pregabalin.

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Lyrica is the brand name for pregabalin, a prescription medicine widely used in the UK for neuropathic pain, generalised anxiety disorder (GAD), and as an adjunctive treatment for epilepsy. It works by binding to the alpha-2-delta subunit of presynaptic voltage-gated calcium channels in the central nervous system, reducing the release of excitatory neurotransmitters and thereby dampening abnormal nerve signalling.

The UK Summary of Product Characteristics (SmPC) for Lyrica, as approved by the Medicines and Healthcare products Regulatory Agency (MHRA) and available via the Electronic Medicines Compendium (emc), lists alopecia (hair loss) as a recognised adverse effect. It is classified as uncommon, defined as affecting between 1 in 1,000 and 1 in 100 people (≥1/1,000 to <1/100) taking the medicine.

It is important to note that 'uncommon' does not mean impossible. Patients who notice changes in hair density or texture whilst taking pregabalin should not dismiss the possibility of a drug-related cause. However, because hair loss has many potential causes — including underlying health conditions, nutritional deficiencies, and other medications — it is essential not to assume pregabalin is responsible without a proper clinical assessment. Always consult your GP or pharmacist before making any changes to your prescribed medication.

Sources: MHRA/emc SmPC for Lyrica (pregabalin); NHS medicines page: Pregabalin.

What the Evidence Says About Pregabalin and Hair Loss

Evidence linking pregabalin to hair loss is limited and largely observational; where reported, it resembles telogen effluvium, but a definitive causal mechanism has not been established in controlled trials.

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The clinical evidence specifically linking pregabalin to hair loss remains limited, and the precise biological mechanism by which it might cause alopecia is not fully understood. Unlike some medicines — such as chemotherapy agents or anticoagulants — that have well-characterised pathways leading to hair loss, pregabalin's effect on hair follicles has not been extensively studied in controlled trials.

Where drug-related hair loss has been described in association with pregabalin, it has generally been characterised as telogen effluvium — a pattern of diffuse scalp shedding in which follicles are pushed prematurely into the resting (telogen) phase. This type of hair loss typically presents as diffuse shedding across the scalp rather than patchy loss, and often begins two to three months after a triggering event, which can make it difficult to attribute directly to a specific drug. It is important to note that this mechanistic explanation remains speculative in the context of pregabalin, as it is not supported by robust peer-reviewed evidence.

Post-marketing surveillance data, including spontaneous reports submitted to the MHRA's Yellow Card scheme, have documented instances of hair loss in patients taking pregabalin, lending some real-world support to the association listed in the SmPC. However, spontaneous reports of this kind indicate suspected adverse reactions only; they cannot be used to determine the incidence of a side effect or to establish a causal relationship. There is no definitive causal proof from large-scale randomised controlled trials. The evidence is largely observational, and confounding factors — such as concurrent medications, stress, or the underlying condition being treated — make it challenging to isolate pregabalin as the sole cause. Clinicians and patients should weigh this uncertainty when evaluating symptoms.

Sources: MHRA/emc SmPC for Lyrica (pregabalin); MHRA Yellow Card scheme.

How Common Is Hair Loss Among Lyrica Users in the UK?

Hair loss is classified as uncommon in the UK SmPC, affecting fewer than 1 in 100 pregabalin users, though given high NHS prescribing volumes this still represents a meaningful number of patients.

Based on the classification in the UK Lyrica SmPC, hair loss is considered an uncommon adverse effect, affecting fewer than 1 in 100 patients (≥1/1,000 to <1/100). To put this in context, more frequently reported side effects of pregabalin include dizziness, somnolence (drowsiness), weight gain, and peripheral oedema (swelling of the hands and feet), all of which are listed as 'very common' or 'common'.

In the UK, pregabalin is among the most widely prescribed medicines; NHS Business Services Authority (NHSBSA) and OpenPrescribing data consistently show high prescribing volumes, particularly for neuropathic pain and anxiety. Given the large number of patients taking the drug, even an 'uncommon' side effect can affect a meaningful number of individuals in absolute terms.

Reports submitted to the MHRA via the Yellow Card scheme — the UK's pharmacovigilance system — provide an additional source of real-world signal data. It is important to understand that Yellow Card reports represent suspected adverse reactions; they do not establish the frequency of a side effect or prove that the medicine caused the reaction. If you believe pregabalin is causing your hair loss, submitting a Yellow Card report nonetheless contributes to national drug safety monitoring and helps regulators identify emerging patterns. You can report online at the MHRA Yellow Card website or via the Yellow Card app. This does not replace seeking medical advice, but it is a valuable step in supporting patient safety at a population level.

Sources: MHRA/emc SmPC for Lyrica (pregabalin); NHSBSA prescribing data/OpenPrescribing; MHRA Yellow Card website.

Other Medications and Conditions That Can Cause Hair Loss

Many medications and conditions — including thyroid disorders, iron deficiency, anticoagulants, and sodium valproate — can cause hair loss, so a full clinical assessment is needed before attributing it to pregabalin.

Before attributing hair loss to pregabalin, it is important to consider the wide range of other potential causes. Hair loss is a common complaint with a broad differential diagnosis, and identifying the correct cause is essential for appropriate management.

Medicines commonly associated with hair loss include (list not exhaustive):

• Anticoagulants such as warfarin and heparin

• Antithyroid drugs (e.g., carbimazole)

• Retinoids (e.g., isotretinoin)

• Beta-blockers

• Certain antidepressants and mood stabilisers

• Antiepileptics such as sodium valproate

• Lithium

• Hormonal contraceptives in some individuals

Medical conditions that can cause hair loss include:

• Androgenetic (male- or female-pattern) hair loss — the most common cause overall

• Hypothyroidism or hyperthyroidism

• Iron deficiency anaemia

• Polycystic ovary syndrome (PCOS)

• Alopecia areata (an autoimmune condition)

• Lupus and other connective tissue disorders

• Nutritional deficiencies, including low ferritin or vitamin D

• Tinea capitis (scalp ringworm), particularly in children

• Scarring alopecias (e.g., lichen planopilaris, frontal fibrosing alopecia) — these require prompt specialist assessment

It is also worth noting that the underlying conditions for which pregabalin is prescribed — such as chronic pain or anxiety — can themselves be associated with stress-related hair loss. Psychological stress is a well-recognised trigger for telogen effluvium, making it particularly difficult to disentangle the role of the medication from the condition it is treating.

A thorough clinical history, including a full medication review and relevant blood tests, is necessary to identify the true cause. In UK primary care, investigations are guided by clinical history and examination; commonly requested initial tests include thyroid function tests, a full blood count, ferritin, and other tests as clinically indicated. The Primary Care Dermatology Society (PCDS) and NICE Clinical Knowledge Summaries (CKS) provide useful guidance for clinicians on the assessment and management of different types of hair loss.

Sources: NICE CKS: Alopecia areata; NICE CKS: Female pattern hair loss; PCDS: Telogen effluvium/diffuse hair loss; NHS: Hair loss (alopecia).

When to Speak to Your GP or Pharmacist

Speak to your GP if hair loss is sudden, patchy, progressive, or accompanied by other symptoms; do not stop pregabalin abruptly, as gradual tapering under supervision is required.

If you are taking pregabalin and have noticed increased hair shedding, thinning, or changes in hair texture, it is advisable to raise this with your GP or pharmacist. Whilst hair loss is rarely a medical emergency, it can cause significant distress and may indicate an underlying issue that warrants investigation.

You should contact your GP if:

• Hair loss is sudden, severe, or rapidly progressive

• You notice patchy hair loss or complete loss in specific areas

• There are signs of scalp inflammation, pustules, or scarring — these may indicate a scarring alopecia or infection (such as tinea capitis, especially in children) and warrant prompt specialist referral

• Hair loss is accompanied by other new symptoms such as fatigue, weight changes, or skin changes

• You are concerned that a medication may be responsible

• Hair loss is affecting your mental health or quality of life

• There is diagnostic uncertainty after initial assessment

Your GP can arrange appropriate blood tests to rule out common medical causes and review your full medication list to identify any potential drug-related contributors. Do not stop taking pregabalin without medical advice. Abrupt discontinuation can cause withdrawal symptoms including insomnia, nausea, headache, and anxiety. The UK SmPC for Lyrica advises that if pregabalin needs to be discontinued, it should be tapered gradually over a minimum of one week under medical supervision.

Your pharmacist is also an accessible first point of contact. They can review your medicines, advise on whether hair loss is a recognised side effect of any of your current treatments, and help you decide whether a GP appointment is necessary. In some cases, a referral to a dermatologist may be appropriate for specialist assessment of hair loss.

Sources: MHRA/emc SmPC for Lyrica (pregabalin) — discontinuation/withdrawal section; PCDS referral guidance for hair loss; NHS: Hair loss (alopecia).

Managing Side Effects While Taking Pregabalin

Management options include dose reduction, switching to an alternative such as amitriptyline or duloxetine, treating any identified underlying cause, and gentle hair care; all changes should be made under medical supervision.

If pregabalin is suspected to be contributing to hair loss, your GP may consider several management strategies. The approach will depend on the severity of the hair loss, how well pregabalin is controlling your underlying condition, and whether alternative treatments are suitable for you. Any decision to adjust or switch medication should involve a documented benefit–risk discussion between you and your clinician.

Possible management options include:

• Dose review: In some cases, reducing the dose of pregabalin may lessen side effects whilst maintaining therapeutic benefit. Any dose reduction should be carried out gradually under medical supervision, in line with the tapering advice in the UK SmPC.

• Switching medication: If pregabalin is not well tolerated, your GP may consider alternative treatments. For neuropathic pain, NICE CKS (Neuropathic pain — pharmacological management) recommends other first-line options such as amitriptyline, duloxetine, or gabapentin, though each carries its own side effect profile and suitability will depend on the individual and the specific condition being treated (for example, duloxetine is a preferred option for painful diabetic neuropathy). For GAD or epilepsy, alternative options will differ and should be discussed with your prescriber.

• Treating an underlying cause: If blood tests reveal a concurrent cause of hair loss — such as iron deficiency or thyroid dysfunction — treating that condition may resolve the hair loss independently of any change to pregabalin.

• Supportive hair care: Whilst not a medical treatment, gentle hair care practices — avoiding excessive heat, tight hairstyles, and harsh chemical treatments — can help minimise further hair breakage during a period of increased shedding.

It is also worth monitoring whether hair loss stabilises or improves over time, as telogen effluvium is often self-limiting once the triggering factor is addressed. Keeping a simple diary of symptoms, including when hair loss began relative to starting or changing your medication, can provide useful information for your healthcare team. Open communication with your GP ensures that any side effects are properly documented and managed in line with your overall care plan.

Sources: MHRA/emc SmPC for Lyrica (pregabalin); NICE CKS: Neuropathic pain — pharmacological management; BNF: Pregabalin.

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