From what I understand, there's a few differences.
First, pregabalin cost a lot more than gabapentin. That's cause gabapentin is generic.
Lyrica (pregablin) is effective for fibromyalgia when gabapentin is not.
gabapentin often requires 1800mg / day to work (built up slowly over time), while pregabalin can be effective at 150mg TID. And the change of side effects build as the does is increased.
If cost is an issue, since gabapentin can be effective for neuropathic pain (at high doses) I'd try the gabapentin first and see what happens. If it doesn't work, then i'd try the Lyrica.
However, if its the difference between a $10 and $25 copay (as it is with my insurance), I'd use the Lyrica to quicken the chance of relief.
But with both medications, be aware of the side effects. I've seen reports here of people having trouble stopping Lyrica once they start -- even though this is not a reported side effect.
Thanks for your advise..I just started Gabapentin yesterday, last night. I have had pain for way too long, feel a bit foggy like in a haze but nerve pain has eased some. I am also taking hydrocoapap 7.5-325. I no longer am able to work so the foggy feeling is better than more pain. What concerns me is long turn usage and if I am able to work up to four 300mg daily and still be able to function. I found out at pharmacy that I could get Lyrica for $3.20 a month..paid $1.10 for Gabapentin. I am covered by Medicare and Medicaid. My Neuopathy pain is from back surgery over 10 years ago and I am trying to ease symptoms by having injections in my back and this new medicine rather than another surgery. I pray one or other I can manage.