Tara Gomes, MHSc Li Ka Shing Knowledge Institute, St Michael’s Hospital, The Institute for Clinical Evaluative Sciences Leslie Dan Faculty of Pharmacy Department of Health Policy, Management, and Evaluation University of Toronto, Toronto, Ontario, Canada

Pregabalin Linked To Increased Risk for Opioid-Related Deaths

MedicalResearch.com Interview with:

Tara Gomes, MHSc Li Ka Shing Knowledge Institute, St Michael’s Hospital, The Institute for Clinical Evaluative Sciences Leslie Dan Faculty of Pharmacy Department of Health Policy, Management, and Evaluation University of Toronto, Toronto, Ontario, Canada

Tara Gomes

Tara Gomes, MHSc
Li Ka Shing Knowledge Institute, St Michael’s Hospital,
The Institute for Clinical Evaluative Sciences
Leslie Dan Faculty of Pharmacy
Department of Health Policy, Management, and Evaluation
University of Toronto, Toronto, Ontario, Canada 

MedicalResearch.com: What is the background for this study?

Response: Pregabalin is a medication increasingly being prescribed to manage pain, however there is emerging evidence that this drug may increase one’s risk of opioid overdose when prescribed with opioids.

MedicalResearch.com: What are the main findings? 

Response: We found that combined prescribing of opioids with pregabalin led to a nearly 70% increased odds of dying of an opioid-related cause compared to treatment with opioids alone. This risk was even higher when prescribed high doses of pregabalin. 

MedicalResearch.com: What should readers take away from your report?

Response: There is a clinically important drug-drug interaction between opioids and pregabalin leading to increased risks of fatal opioid overdoses. Clinicians should be cautious when co-prescribing opioids with pregabalin, particularly at high doses.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Given the novelty of this finding, future research is needed to confirm these findings. It would be particularly useful to replicate this study in a cohort of younger individuals, as our study was restricted to the elderly. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: The current pregabalin product monograph does not include warnings regarding the use of this medication with opioids. Given the findings of this study, we suggest that a warning is included so that clinicians and patients are aware of these risks.

Disclosure: This study was funded by a grant from the Ontario Ministry of Health and Long-Term Care.

Citation: 

Gomes T, Greaves S, van den Brink W, Antoniou T, Mamdani MM, Paterson JM, et al. Pregabalin and the Risk for Opioid-Related Death: A Nested Case–Control Study. Ann Intern Med. [Epub ahead of print 21 August 2018] doi: 10.7326/M18-1136

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Last Updated on August 21, 2018 by Marie Benz MD FAAD