Patients on gabapeninoids (gabapentin and pregabalin) for pain or epilepsy that have COPD are up to 1.5 times more likely to have a severe exacerbation. This scares me.
Rahman, Alvi A., et al.
Gabapentinoids and Risk for Severe Exacerbation in Chronic Obstructive Pulmonary Disease: A Population-Based Cohort Study.
Annals of Internal Medicine (2024).
https://www.acpjournals.org/doi/full/10.7326/M23-0849
“Compared with nonuse, gabapentinoid use was associated with increased risk for severe COPD exacerbation across the indications of epilepsy (HR, 1.58 [95% CI, 1.08 to 2.30]), neuropathic pain (HR, 1.35 [CI, 1.24 to 1.48]), and other chronic pain (HR, 1.49 [CI, 1.27 to 1.73]) and overall (HR, 1.39 [CI, 1.29 to 1.50]).”
Comment – gabapentinoids do not work well in back, neck, and sciatica pains and should be avoided if COPD (maybe in all cases). If subject has severe COPD exacerbations, should be avoided.