Gabapentin and Pregabalin Are Associated with Severe COPD Exacerbations

In 2019, the U.S. Food and Drug Administration issued a warning related to nearly 50 case reports of breathing difficulties following use of gabapentinoids (i.e., gabapentin and pregabalin) that were reported between 2012 and 2017; however, such warnings are not reflected in current pain management guidelines. To explore this issue further, Canadian investigators retrospectively studied a cohort of patients with chronic obstructive pulmonary disease (COPD): 14,000 new users of gabapentinoids were propensity matched with 14,000 nonusers, based on duration of COPD, age, sex, and gabapentinoid indication.

Gabapentinoid use was associated with significantly higher risk for severe COPD exacerbations requiring hospitalization (15.1% vs. 8.3% annua…