A recent article in Pain Medicine News highlights a Canadian study, published in PLoS Medicine, that reported patients taking prescription opioids and gabapentin concomitantly had a 49% greater risk for opioid-related death than those treated with opioids only.
The researcher team used administrative databases to compare opioid users who died of an opioid-related cause with controls who were selected in a 4:1 ratio and matched on age, sex, year of index date, history of chronic kidney disease and a disease risk index (PLoS Med 2017;14:e1002396). The primary exposure was concomitant gabapentin use during the 120 days preceding the index date.
Among opioid users with an opioid-related death, 12.3% were prescribed gabapentin during the previous 120 days, compared with 6.8% of controls. The researchers found that the combination of opioids and gabapentin was associated with a 49% increased odds of opioid-related death over an opioid prescription alone. The increased risk persisted after multivariable adjustment for confounders such as opioid dose, use of other medications, number of other drugs being taken, alcohol use, and illnesses such as diabetes or chronic lung disease.
The study suggests clinicians should take great caution when combining gabapentin and opioids. Patients treated with opioids and gabapentin should be closely monitored and may need to have their doses adjusted to avoid potential drug overdose.
Pain Medicine News Article Full PLoS Study