FDA Gabapentinoid Safety Communication

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FDA says that serious breathing difficulties may occur in patients using gabapentin (Pfizer's Neurontin, Assertio’s Gralise, Arbor’s Horizant) or pregabalin (Pfizer’s Lyrica and Lyrica CR) who have respiratory risk factors. In a drug safety communication, the agency said its evaluation showed that the use of the gabapentinoids has been growing for prescribed medical use, as well as misuse and abuse.

“Gabapentinoids are often being combined with central nervous system depressants, which increases the risk of respiratory depression,” the notice said. “Central nervous system depressants include opioids, anti-anxiety medicines, antidepressants, and antihistamines. There is less evidence supporting the risk of serious breathing difficulties in healthy individuals taking gabapentinoids alone.”

As a result of its findings, the agency said it is requiring that new warnings about the risk of respiratory depression be added to gabapentinoid labeling. It also is requiring the drugs’ manufacturers to conduct clinical trials to further evaluate the abuse potential, particularly in combination with opioids, because of the increasing misuse and abuse of the products together. Special attention will be paid to the respiratory depressant effects during the abuse potential evaluation, FDA said.

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