The U.S. Food and Drug Administration (FDA) lists Lyrica in Pregnancy Category C. This indicates that caution is advised, but the benefits of the medication may outweigh the potential risks. There have been no good scientific studies in women, but studies in animals have shown some harm to the fetus.

In general, the risk of birth defects is higher for women who take combinations of seizure medicines during their pregnancy and for women with a family history of birth defects. Whether this applies to Lyrica is not yet known.

Women who are capable of becoming pregnant should take at least 400 micrograms (0.4 mg) of folic acid (folate) daily to help prevent a type of birth defect called a neural tube defect. (The best-known of these is spina bifida, in which the spinal cord is not completely enclosed.) Women at high risk, such as those with a history of this kind of defect in a previous pregnancy, should take 4000 micrograms (4 mg) daily, beginning before they become pregnant.

About 20% to 35% of women have seizures more often during pregnancy because of changes in hormones or changes in how their seizure medicine is handled by the body. Even though this may not apply to Lyrica, the doctor may recommend checking the level of medication in the blood regularly during pregnancy so that the dosage can be adjusted as needed.

It is not yet known if Lyrica is found in human breast milk, but it is likely to be. The effect, if any, on the infant is unknown.

Reviewed October 2005 by Steven C. Schachter, MD, epilepsy.com Editorial Board.