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Respiratory risk factors were present in 92% of cases. FDA is mandating a warning of respiratory depression be added to the package inserts for gabapentin and pregabalin. Manufacturers of gabapentin and pregabalin are required to conduct clinical trials evaluating the proper use of these medications in combination with opioids. Gabapentin and pregabalin are FDA-approved for a variety of conditions, including of respiratory depression. CNS depressants include opioids, anti-anxiety medicines, etrospectively reviewed the electronic health records of 8567 patients who underwent major laparoscopic procedures (lasting ≥90 minutes) from January 1, 2010, to July 31, 2014. We assessed potential associations among patient and perioperative variables and episodes of respiratory depression during phase-I recovery. Multivariable and propensity score–matched analyses were performed to The review linked gabapentin or pregabalin to 49 cases of respiratory depression from 2012 to 2017. In 92% of those cases, the person had a respiratory risk factor, and 12 of the 49 people died. In a recent Drug Safety Update, the Medicines and Healthcare products Regulatory Agency (MHRA) warned about a rare risk of severe respiratory depression with gabapentin, with or without concomitant use of opioids. 1 In England, 6.5 million prescriptions for gabapentin were dispensed in 2016. 2 Gabapentinoids (gabapentin and pregabalin) are frequently prescribed with opioids for their opioid-sparing and adjuvant analgesic effects. There is limited literature on the risk of respiratory depression due to the combination of opioids and gabapentinoids requiring naloxone administration. Pregabalin has been associated with infrequent reports of severe respiratory depression, including some cases without the presence of concomitant opioid medicines. Patients with compromised In 2019 the FDA issued a warning about the potential risks of respiratory depression in patients taking gabapentin or pregabalin in combination with central nervous system (CNS) depressants such as opioids, antidepressants, and benzodiazepines. Yes, gabapentin can affect respiratory health. While gabapentin is widely prescribed for nerve pain, seizures, and other conditions, it carries a significant risk of respiratory depression, particularly in individuals with pre-existing respiratory conditions or when used in conjunction with other central nervous system depressants. This article The changes made in the revised version highlights two additional high risk population category for developing gabapentinoids induced respiratory depression such as patients with concurrent opioid use and patients administered with gabapentinoids on the day of surgery. The agency said it received 49 case reports of serious breathing problems in patients taking gabapentinoids, including 12 people who died from respiratory depression. It’s advising doctors, caregivers and patients taking gabapentinoids to be alert for signs of confusion, disorientation, dizziness, sleepiness, slow or shallow breathing Starting gabapentinoids at a low dose and titrating carefully is recommended to reduce the risk of respiratory depression in patients with respiratory risk factors and in the elderly. Reductions in the dosage of gabapentin and pregabalin are necessary in patients with renal impairment. Gabapentinoids are often being combined with CNS depressants, which increases the risk of respiratory depression. There is less evidence supporting the risk of serious breathing FDA is warning that serious, life-threatening, and fatal respiratory depression has been reported with the gabapentinoids, gabapentin (Neurontin, Gralise, Horizant) and pregabalin (Lyrica, Lyrica FDA is requiring new warnings about the risk of serious breathing difficulties that can lead to death in patients who use gabapentanoids with opioid pain medicines or other drugs that depress the Although these drugs, which include gabapentin (Neurontin) and pregabalin (Lyrica), are still believed to be far safer than opioids for long-term use, the U.S. Food and Drug Administration is now warning that they may cause “respiratory depression.” That means your breathing could become so slow and shallow that you end up with too much Adding a sedative-hypnotic when someone is already taking a gabapentinoid together with an opioid increases the risk of opioid-induced respiratory depression. From a pharmacological perspective, the following additional drugs pose the greatest danger: Gabapentin has been associated with a rare risk of severe respiratory depression even without concomitant opioid medicines. Understanding Gabapentin-Induced Respiratory Depression How Gabapentin Affects Breathing. Gabapentin and its close relative, pregabalin, are known as gabapentinoids. While not opioids, these drugs can depress the central nervous system, which includes the area of the brain that controls breathing. The agency is warning that serious breathing difficulties may occur in patients using gabapentin (Neurontin, Gralise, Horizant) or pregabalin (Lyrica, Lyrica CR) who have respiratory risk factors. Among those factors are use of opioid pain medicines and other drugs that depress the central nervous system (CNS), as well as conditions such as
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