FDA MedWatch: Gabapentin and Pregabalin Linked to Respiratory Depression Risk

(FDA)—Serious respiratory depression may occur in pts using gabapentin (Neurontin, Gralise, Horizant) or pregabalin (Lyrica, Lyrica CR) who have respiratory risk factors, including use of central nervous system depressants (ie, opioids) or presence of lung dz such as COPD. The elderly are also at risk. FDA is mandating that the drugs carry new warnings and that manufacturers conduct trials to further evaluate their abuse potential, especially when used in combination w/ opioids. Prescribe gabapentinoids at the lowest possible dose and monitor for sx such as confusion/disorientation, unusual dizziness/presyncope, extreme somnolence/lethargy, slowed/shallow breathing or dyspnea, unresponsiveness, and cyanosis.