Anticonvulsant With Opioids Tied To Higher Mortality

Treatment with pregabalin (Lyrica), an anticonvulsant also approved for several forms of chronic pain, was associated with an increased risk for opioid-related death when co-prescribed with opioids, Canadian researchers reported.

Among some 6,500 residents of Ontario with opioid prescriptions — including 1,417 who subsequently died from an opioid-related cause — concomitant exposure to pregabalin and opioids was associated with significantly increased odds of opioid-related death compared with exposure to opioids alone (adjusted OR 1.68, 95% CI 1.19-2.36), reported Tara Gomes, MHSc, PhD, of the Institute for Clinical Evaluative Sciences (ICES) and St. Michael’s Hospital in Toronto, and colleagues.

A high dose of pregabalin (defined as >300 mg/d) was associated with substantially increased odds of opioid-related death relative to no pregabalin exposure (adjusted OR 2.51, 95% CI 1.24-5.06). A low or moderate dose (≤300 mg/d) was associated with relatively lower, but still significantly increased, odds of opioid-related death (adjusted OR 1.52, 95% CI 1.04-2.22), they wrote in the Annals of Internal Medicine.

Pregabalin and opioids may lead to a potentially life-threatening interaction similar to one previously observed with gabapentin (Neurontin) and opioids, the researchers suggested.

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