Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case–control study - HHM

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Tuesday, 3 October 2017

Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case–control study

Tara Gome,

  • David N. Juurlink,
  • Tony Antoniou,
  •  Muhammad M. Mamdani,
  • J. Michael Paterson,
  • Wim van den Brink









  • Prescription opioid use is highly associated with risk of opioid-related death, with 1 of every 550 chronic opioid users dying within approximately 2.5 years of their first opioid prescription. 

    Although gabapentin is widely perceived as safe, drug-induced respiratory depression has been described when gabapentin is used alone or in combination with other medications. Because gabapentin and opioids are both commonly prescribed for pain, the likelihood of co-prescription is high. 

    However, no published studies have examined whether concomitant gabapentin therapy is associated with an increased risk of accidental opioid-related death in patients receiving opioids. 

    The objective of this study was to investigate whether co-prescription of opioids and gabapentin is associated with an increased risk of accidental opioid-related mortality.


    In this study we found that among patients receiving prescription opioids, concomitant treatment with gabapentin was associated with a substantial increase in the risk of opioid-related death. 

    Clinicians should consider carefully whether to continue prescribing this combination of products and, when the combination is deemed necessary, should closely monitor their patients and adjust opioid dose accordingly. 

    Future research should investigate whether a similar interaction exists between pregabalin and opioids.



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