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Edema is an established, but perhaps not widely known, side effect of gabapentinoids. Prior research has demonstrated that gabapentinoid initiation can lead to prescription of loop diuretics, a so-called “prescribing cascade” (NEJM JW Gen Med Dec 1 2021 and J Am Geriatr Soc 2021; 69:2842). In this study, U.S. Veterans Affairs researchers confirmed that cascade and looked for potential risk factors among 150,000 patients (age, ≥65) who started gabapentinoids.
About 1600 patients started loop diuretics during the 6 months before gabapentinoid initiation, and 2000 started loop diuretics during the 6 months after — a 23% increase, according to adjusted analyses. The estimated incidence of the cascade was 5 events per 1000 gabapentinoid-initiator…