Prescribing Patterns of Gabapentinoids in Patients with Chronic Obstructive Pulmonary Disorder

In 2019, the U.S. Food and Drug Administration (FDA) issued a warning regarding the risk of serious respiratory depression in patients using gabapentin or pregabalin who have respiratory risk factors, including those with chronic obstructive pulmonary disorder (COPD). With the overall prescribing of gabapentinoids continuing to grow, there is the potential for inappropriate prescribing in this patient population. Data from the National Ambulatory Medical Care Survey (NAMCS) from 2013 to 2018, with the exception of 2017, was used to assess prevalence and predictors of gabapentinoid prescribing in patients with COPD. The data consists of 1,131 unweighted visits, representing approximately 53.6 million ambulatory care visits nationally. Of these visits, 146 patients (10.8%) with a COPD diagnosis were also prescribed a gabapentinoid, which represents more than a million office visits annually when weighted. Patients with an increased risk of receiving gabapentinoids were those with concomitant diabetes mellitus, concurrent opioid use, and those currently using tobacco. Due to increased risk of serious respiratory depression caused by gabapentinoids, prescribers should take caution when prescribing to individuals with COPD and other respiratory risk factors. Based on the reviewed prescribing patterns, more education is needed to inform providers about the risks associated with concomitant COPD and gabapentinoid use.