| Fibromyalgia
Savella vs Lyrica
Side-by-side clinical, coverage, and cost comparison for fibromyalgia.Deep comparison between: Savella vs Lyrica with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsLyrica has a higher rate of injection site reactions vs Savella based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Lyrica but not Savella, including UnitedHealthcare
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Category
Savella
Lyrica
At A Glance
Oral
Twice daily
SNRI
Oral
2-3 times daily
alpha2-delta calcium channel ligand
Indications
- Fibromyalgia
- Peripheral Nervous System Diseases
- Epilepsy
- Fibromyalgia
- chronic pain (diagnosis)
Dosing
Fibromyalgia Titrate over 7 days to recommended dose of 100 mg/day (50 mg twice daily); may increase to 200 mg/day based on individual response; reduce maintenance dose by 50% to 50 mg/day (25 mg twice daily) in severe renal impairment (CLcr 5-29 mL/min); taper and do not abruptly discontinue after extended use.
Peripheral Nervous System Diseases Begin at 150 mg/day in 3 divided doses; may increase to max 300 mg/day within 1 week; oral.
chronic pain (diagnosis) PHN: begin at 150 mg/day (75 mg BID or 50 mg TID), max up to 600 mg/day. Spinal cord injury neuropathic pain: begin at 150 mg/day (75 mg BID), max 600 mg/day; oral.
Epilepsy Adults: begin at 150 mg/day in 2 or 3 divided doses, max 600 mg/day. Pediatric >=30 kg: begin 2.5 mg/kg/day, max 10 mg/kg/day. Pediatric <30 kg: begin 3.5 mg/kg/day, max 14 mg/kg/day; oral.
Fibromyalgia Begin at 150 mg/day (75 mg BID); may increase to 300 mg/day within 1 week; max 450 mg/day; oral.
Contraindications
- Concurrent use or use within 5 days of stopping SAVELLA with MAOIs intended to treat psychiatric disorders, or initiation within 14 days of stopping such an MAOI
- Initiation of SAVELLA in patients currently being treated with linezolid or intravenous methylene blue
- Known hypersensitivity to pregabalin or any of its components
Adverse Reactions
Most common (>=5%) Nausea, headache, constipation, dizziness, insomnia, hot flush, hyperhidrosis, vomiting, palpitations, heart rate increased, dry mouth, hypertension
Postmarketing Leukopenia, neutropenia, thrombocytopenia, supraventricular tachycardia, Takotsubo cardiomyopathy, acute pancreatitis, hepatitis, hyponatremia, rhabdomyolysis, convulsions, Stevens Johnson syndrome, hypertensive crisis
Most common (>=5%) Dizziness, somnolence, dry mouth, edema, blurred vision, weight gain, thinking abnormal
Serious Angioedema, hypersensitivity, suicidal behavior and ideation, respiratory depression, peripheral edema, weight gain, tumorigenic potential, ophthalmological effects, creatine kinase elevations, decreased platelet count, PR interval prolongation
Postmarketing Headache, nausea, diarrhea, gynecomastia, breast enlargement, bullous pemphigoid, life-threatening respiratory depression with opioids or CNS depressants
Pharmacology
SNRI; milnacipran is a potent inhibitor of neuronal norepinephrine and serotonin reuptake, inhibiting norepinephrine uptake with approximately 3-fold higher potency than serotonin in vitro, without directly affecting dopamine uptake or binding at serotonergic, adrenergic, muscarinic, histamine, dopamine, opiate, benzodiazepine, or GABA receptors.
Pregabalin binds with high affinity to the alpha2-delta site (an auxiliary subunit of voltage-gated calcium channels) in CNS tissues, reducing calcium-dependent release of pro-nociceptive neurotransmitters in the spinal cord and exerting antiseizure effects; it is a structural GABA analogue but does not act directly on GABA receptors, sodium channels, or opiate receptors.
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Most Common Insurance
Anthem BCBS
Savella
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (3/12) · Qty limit (9/12)
Lyrica
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (9/12)
UnitedHealthcare
Savella
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (2/8) · Qty limit (6/8)
Lyrica
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (4/8)
Humana
Savella
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Lyrica
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Savella.
No savings programs available for Lyrica.
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Next Steps for Your Patient
SavellaView full Savella profile
LyricaView full Lyrica profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.