topic Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica in Community Chat

New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

Mindy D — Fri, 20 Dec 2019 20:14:05 GMT

There is a new warning about the use of Gabapentin respiratory complications in a drug safety communication issued today. If you use this medication you might want to read this and of course consult your physician or pharmacist if you have questions.

“FDA warns about serious breathing problems with seizure and nerve pain medicines gabapentin (Neurontin, Gralise, Horizant) and pregabalin (Lyrica, Lyrica CR)
When used with CNS depressants or in patients with lung problems
12-19-2019
What safety concern is FDA announcing?
The U.S. Food and Drug Administration (FDA) is warning that serious breathing difficulties may occur in patients using gabapentin (Neurontin, Gralise, Horizant) or pregabalin (Lyrica, Lyrica CR) who have respiratory risk factors. These include the use of opioid pain medicines and other drugs that depress the central nervous system, and conditions such as chronic obstructive pulmonary disease (COPD) that reduce lung function. The elderly are also at higher risk.
Gabapentin and pregabalin are FDA-approved for a variety of conditions, including seizures, nerve pain, and restless legs syndrome.
Our evaluation shows that the use of these medicines, often referred to as gabapentinoids, has been growing for prescribed medical use, as well as misuse and abuse. ✅Gabapentinoids are often being combined with CNS depressants, which increases the risk of respiratory depression. ✅CNS 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. We will continue to monitor these medicines as part of our routine monitoring of all FDA- approved drugs.”

Click on the words “drug safety communication” in paragraph 1, to read the link to the FDA communication.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

jonim — Fri, 20 Dec 2019 13:06:19 GMT

Thank you for sharing this info. I was not aware of this , Used lyrica for years.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

Anonymous032819 — Fri, 20 Dec 2019 13:57:14 GMT

So, it's Gabpentin in combination with other medicine that can cause breathing problems.

But Gabpentin by itself doesn't cause breathing problems.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

chrystaltree — Fri, 20 Dec 2019 17:19:58 GMT

I take Gabapentin, it gave me back my life. I don't have any respiratory issues and I'm not taking any cns depressants so this does not apply to me. Honestly, when I weigh chronic disabling pain against the risks....I'd have to weigh them very carefully before I would consider going off the Gabapentin.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

Still Raining — Fri, 20 Dec 2019 17:05:55 GMT

This is not really news to any of my doctors. They keep asking about how I am with the drug cocktail I am on.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

SandySparkles — Fri, 20 Dec 2019 17:22:43 GMT

Thank you for another interesting article Mindy. I appreciate any article that relates to public health or safety, because I love researching medical claims. Some turn out to be bogus, but are interesting nonetheless.

~~~All we need is LOVE💖

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

chrystaltree — Fri, 20 Dec 2019 17:23:56 GMT

@Still Raining wrote:
This is not really news to any of my doctors. They keep asking about how I am with the drug cocktail I am on.

It's not news to any doctor. Gabapentin has been around and in use for many years now, the risks and contraindications are know. However, they are prescribing it or off label uses now.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

Mindy D — Fri, 20 Dec 2019 20:06:10 GMT

@jonim wrote:
Thank you for sharing this info. I was not aware of this , Used lyrica for years.

@jonim No one is aware of this. This is a brand new warning alert for doctors and pharmacists. Your doctor and pharmacist should just be getting this alert right now. They might not have read this yet.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

Mindy D — Fri, 20 Dec 2019 20:11:26 GMT

@chrystaltree wrote:
I take Gabapentin, it gave me back my life. I don't have any respiratory issues and I'm not taking any cns depressants so this does not apply to me. Honestly, when I weigh chronic disabling pain against the risks....I'd have to weigh them very carefully before I would consider going off the Gabapentin.

@chrystaltree Hi Crystaltree. Just to be clear, here’s a quote from the warning.

Our evaluation shows that the use of these medicines, often referred to as gabapentinoids, has been growing for prescribed medical use, as well as misuse and abuse. Gabapentinoids are often being combined with CNS depressants, which increases the risk of respiratory depression. CNS 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. We will continue to monitor these medicines as part of our routine monitoring of all FDA- approved drugs.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

Mindy D — Fri, 20 Dec 2019 20:15:46 GMT

@Still Raining wrote:
This is not really news to any of my doctors. They keep asking about how I am with the drug cocktail I am on.

@Still Raining This is the first time that this warning is being sent to physicians and pharmacists.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

SunSprite — Fri, 20 Dec 2019 20:24:40 GMT

@Mindy D I'm not speaking for anyone else, but I think some doctors had already figured out the dangers of being on gaba and other depressant type drugs.

My sister was in ICU back in September; she is a gaba user. She had terrible sharp pain and the ICU nurse talked to us about why they weren't giving her anything to help with that. She said the risks of being on gaba and in my sister's condition made that too dangerous. My sister takes gaba long term for neuropathy. Her pain in ICU was not related to neuropathy.

I understand that this warning might have just come out--I just think some physicians probably already considered it risky to combine with depressant type drugs.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

chrystaltree — Fri, 20 Dec 2019 20:31:54 GMT

@SunSprite wrote:
@Mindy D I'm not speaking for anyone else, but I think some doctors had already figured out the dangers of being on gaba and other depressant type drugs.
My sister was in ICU back in September; she is a gaba user. She had terrible sharp pain and the ICU nurse talked to us about why they weren't giving her anything to help with that. She said the risks of being on gaba and in my sister's condition made that too dangerous. My sister takes gaba long term for neuropathy. Her pain in ICU was not related to neuropathy.

I understand that this warning might have just come out--I just think some physicians probably already considered it risky to combine with depressant type drugs.

They don't understand that while this warning might have just been released, it's been in professional journals and seminar and peer discussions and clinical policies....for years. It's just been made official.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

Laura14 — Fri, 20 Dec 2019 20:38:30 GMT

Neurotransmitters (which is what gaba works on) have a significant role in respiration. It's how your body works.

Combine a drug which is affecting that along with a depressant which is easy to do since most pain relievers are coprescribed for pain relief and you have a common sense innate heads up to any pharmacist or doctor worth their license.

Still, kudos to the the system working as it should and putting out a reminder especially this time of year when pharmacies and doctor offices are beyond busy with holiday travelers and flu patients.

Thank you @Mindy D for empowering patients to watch us. Always great to question your drugs and any potential interactions before you end up in the ER or worse.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

SilleeMee — Fri, 20 Dec 2019 21:04:14 GMT

It was prescribed to me for nerve pain associated with my scleroderma. I took it for a very long time and never had any problems with it. I thank the heavens for that doctor who gave me a Rx for it rather than an opioid back then when I had the pain. I would be in a different boat now had that doctor gave me an opioid at that time in my life.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

pitdakota — Fri, 20 Dec 2019 22:39:59 GMT

@Mindy D wrote:
@jonim wrote:
Thank you for sharing this info. I was not aware of this , Used lyrica for years.
@jonim No one is aware of this. This is a brand new warning alert for doctors and pharmacists. Your doctor and pharmacist should just be getting this alert right now. They might not have read this yet.

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Hi @Mindy D! This is not new information for health care professionals. This information has been out there among professionals for some time. As @Laura14 stated, this is how this classification of medications work and when prescribed with other medications that also have the potential to depress the respiratory system, it bears certain monitoring or assessment.

It might be the first warning sent as just a reminder to healthcare professionals because our population is increasing and aging at the same time so this classification of medication is prescribed more often and may be prescribed in conjunction with other medications that call for special considerations or monitoring of certain patients.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

Mindy D — Fri, 20 Dec 2019 23:17:54 GMT

I agree that some doctors have figured this out. There’s been discussions of this.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

pitdakota — Fri, 20 Dec 2019 23:34:24 GMT

@Mindy D wrote:
I agree that some doctors have figured this out. There’s been discussions of this.

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@Mindy D,it really isn't that some doctors have figured this out. This is information both doctors, pharmacists, nurses, etc. learn in pharmacology. I taught this information to nursing students in their advanced pharmacology course and I have been retired for a couple of years now.

When a certain classification of a drug works a certain way, it can also have impacts on other systems that needs to be monitored. This information is covered quite throughly and usually tested extensively in school.

It is just like beta blockers and how they work & are prescribed in certain cardiac situations. However, because of how they work, they cause narrowing of parts of the airway so they are not usually prescribed in patients diagnosed with COPD. This would not normally be information that the lay public would know. Some people that have had experience with COPD and heart problems might know, but it isn't something that the majority of the public might know.

But as with all things, it never hurts for professionals to be reminded. And as we people are living longer with more chronic diseases, the use of various classifications of medications becomes more common...thus the need for healthcare professionals to be viligant!

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

Still Raining — Sat, 21 Dec 2019 00:19:46 GMT

@Mindy D wrote:
@Still Raining wrote:
This is not really news to any of my doctors. They keep asking about how I am with the drug cocktail I am on.
@Still Raining This is the first time that this warning is being sent to physicians and pharmacists.

This is not news.

If you are on gabapentin, a beta blocker, and an antidepressant along with pain meds, you will always have a consult with the pharmacist. If different specialists are doing the prescriptions that is covered.

Anesthesiologists also are cautious. Shucks I even had a tube for a 15 minute cataract removal.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

Drythe — Sat, 21 Dec 2019 05:38:12 GMT

@Mindy D wrote:
@jonim wrote:
Thank you for sharing this info. I was not aware of this , Used lyrica for years.
@jonim No one is aware of this. This is a brand new warning alert for doctors and pharmacists. Your doctor and pharmacist should just be getting this alert right now. They might not have read this yet.

@Mindy D

Respectfully, many people are aware of this. It has been in journals and seminars for a good while.

The FDA relies on reports from Physician / Pharmacists to tell them about issues their patients experience while taking a drug. After the FDA receives reports from Physician / Pharmacists, the FDA review them, and draws correlations, only after that do they send out the type of warning in your OP.

So, while this general public warning just came out today, the information it is based on came from Physicians and Pharmacists. The FDA is not a clinical facility, it’s job is administrative. So, this is not a brand new warning that no one was aware of.

I teach in the field of Health Care, I’ve been teaching this contraindication for a good bit. It is interesting and important to follow such information for yourself. But, it is good to gain an understanding of how the US Public Health System works, and keep alerts in the appropriate context so as not to alarm people.

Re: New warning about Gabpentin and serious breathing problems. Neurontin,Gralise,Horizant, Lyrica

NYC Susan — Sun, 22 Dec 2019 06:17:33 GMT

@chrystaltree wrote:
I take Gabapentin, it gave me back my life. I don't have any respiratory issues and I'm not taking any cns depressants so this does not apply to me. Honestly, when I weigh chronic disabling pain against the risks....I'd have to weigh them very carefully before I would consider going off the Gabapentin.

I understand what you're saying. I would not be able to function without gabapentin. I have been taking it for years, with no side effects and no problems at all. It has been a miracle medication for me. I'm glad it has been so helpful to you, too.