Many of the patients we see in the office and in a hospital setting are on multiple medications. Finding that some of these medications may interact with one another is common. Some of these interactions do not require stopping the medications but may only require changing the dose. A more concerning problem is when the medication may have a negative effect on one or more of a patient’s problems.
Gabapentin is an anticonvulsant drug indicated for epilepsy and neuropathic pain.
However, prescriptions for this drug have surged partly due to so-called off-label prescribing. The perception of the drug may be that it is a safer alternative to opioids.
I would like our COPD patients to take note of recent study evidence that has shown the use of gabapentinoids such as gabapentin was associated with an increased risk of severe exacerbation in patients with COPD. Not only was there an association with moderate to severe exacerbations but also respiratory failure.
In addition, a study of patient without sleep apnea had more apnea, hypopneas and a higher oxygen desaturation index when on this drug.
Do not stop taking gabapentin if your physician has prescribed it for you. It is a valuable therapy for many patients. However, if you have COPD and are experiencing increased symptoms or exacerbations, discuss this with your physician. Patients who have sleep apnea should also have a discussion with their sleep specialist about the possible role gabapentin may play in any of their symptoms.
