COPD: A gabapentin side effect

[NHE]

Surprising Gabapentin Side Effects

Doctors are prescribing gabapentin off-label for pain, etc. Watch out! Gabapentin side effects can be serious. Stopping it can be difficult.

https://www.peoplespharmacy.com/article ... de-effects

The Food and Drug Administration first approved Neurontin (gabapentin) in 1993 to treat epilepsy. Anticonvulsants are not normally blockbuster drugs. Perhaps that is why the original manufacturer, Parke-Davis, promoted the drug off-label to treat pain. You will read about the mischief that caused shortly. The marketing campaign was incredibly successful, though. Gabapentin has become one of the most frequently prescribed pain pills in America. Over 10.5 million patients take it daily. Prescriptions are up, in large part because doctors have cut back on opioid prescribing. Do doctors adequately warn patients about gabapentin side effects and withdrawal reactions? There is a new and unexpected complication: COPD (chronic obstructive pulmonary disease).

COPD: An Unexpected and Worrisome Complication!

Most people are swallowing gabapentin for conditions that the FDA has never approved and for which there may be modest scientific support. We would not get overly concerned with this off-label prescribing if this drug were perfectly safe. But gabapentin side effects are not trivial, as you will read. And a brand new gabapentin side effect has just emerged.

Canadian researchers have just dropped a bombshell on gabapentin (Annals of Internal Medicine, Jan. 15, 2024). They compared patients taking gabapentinoids (gabapentin and pregabalin) with “nonusers.” This was a big database!

• There were 356 gabapentinoid users with epilepsy

• There were 9,411 gabapentinoid users with nerve pain

• There were 3,737 gabapentinoid users with chronic pain

These patients were matched 1:1 to similar people not taking gabapentinoids.

The authors point out that published studies:

"...have shown severe breathing difficulties in some patients using gabapentinoids.

"This safety issue may be of particular concern in patients with respiratory disease, such as chronic obstructive pulmonary disease (COPD).”

Here is what they found:

"In this population-based cohort study of patients with COPD, gabapentinoid use was associated with increased risk for severe exacerbation in patients with epilepsy, neuropathic pain, and other chronic pain. The increased risk was observed regardless of age, sex, and various markers of COPD severity. Gabapentinoid use may also be associated with increased risks for moderate or severe exacerbation and respiratory failure.”

The FDA does list “serious breathing problems” in the official prescribing information for gabapentin:

“Serious breathing problems can occur when NEURONTIN is taken with other medicines that can cause severe sleepiness or decreased awareness, or when it is taken by someone who already has breathing problems. Watch for increased sleepiness or decreased breathing when starting NEURONTIN or when the dose is increased. Get help right away if breathing problems occur.”

We worry, though, that many health professionals may not warn patients who have COPD or other “breathing problems” that gabapentinoids could be dangerous.

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