Gabapentinoids and Respiratory Issues

In 2019, the U.S. FDA issued an alert for gabapentinoids (i.e., gabapentin and pregabalin) that cited potential “serious breathing issues” in patients with respiratory risk factors. Japanese researchers conducted two large parallel studies to examine respiratory complications among patients with underlying lung disease (asthma or chronic obstructive pulmonary disease [COPD] who initiated gabapentinoids. In both studies, the active comparators were medications that commonly are used to manage chronic pain: tricyclic antidepressants (TCAs) and serotonin norepinephrine reuptake inhibitors (SNRIs). Follow-up in both studies was based on the duration of gabapentinoid prescriptions (median, 60 days).