Side Effects of Neurontin, Similar Drugs May Worsen COPD Symptoms, Researchers Warn

Individuals with chronic obstructive pulmonary disease (COPD) who use drugs like Neurontin may face an increased risk of suffering worse respiratory symptoms, when compared to individuals who do not use the drugs, according to the findings of a new study.

In a report published this week in the Annals of Internal Medicine, Canadian researchers warn that patients with COPD taking gabapentin drugs, which includes Neurontin, Horizant, Gaba-V and other anticonvulsants, are more likely to experience serious side effects, including respiratory failure and death.

COPD is a term used to describe a group of conditions that result in airflow blockage and problems with breathing. The term includes diagnoses for emphysema and chronic bronchitis. It makes breathing difficult and causes damage to the lungs, potentially resulting in complications like pneumonia and reduced life expectancy.

Gabapentin Risks for COPD Patients

The researchers studied more than 13,000 patients over the age of 55, using data from three health insurance databases in Quebec, Canada from 1994 and 2015. Patients with COPD who began therapy with a gabapentin drug, like Neurontin or Horizant, and had one of three conditions were matched with patients who didn’t use gabapentin drugs.

COPD patients were divided into three groups, including 365 who had epilepsy, 9,400 who had neuropathic pain, and 3,700 with other chronic pain like fibromyalgia or other conditions.

According to the findings, patients taking gabapentin drugs had a 39% higher risk of experiencing severe exacerbations to their COPD compared with non-users. They also faced a higher risk of respiratory failure, hospitalization and death.

Researchers said the findings were consistent across age, sex, and COPD severity and affected patients with epilepsy, neuropathic pain, and other chronic pain conditions.

Neurontin and Other Anticonvulsant Risks

Neurontin and other gabapentin drugs fall into a class of medications known as anticonvulsants. They are prescribed for seizures, but are also used off-label for pain and problems affecting the nerves, such as diabetic neuropathy, fibromyalgia and for menopause symptoms.

Off-label prescribing has increased across the U.S. in recent years, largely due to the opioid epidemic. Drugs like Neurontin are often considered safer alternatives to habit-forming opioids.

However, Neurontin and Horizant are not effective for most off-label indications, researchers warn. In the U.S. and Europe, health agencies like the U.S. Food and Drug Administration issued warnings about severe breathing problems linked to gabapentin drugs, including for patients with COPD, in 2019.

Other research has linked the use of Neurontin and Horizant to an increased risk of suicide, overdoses, and other adverse events.

Gabapentin drugs are linked to an increased risk of respiratory failure because they can cause central nervous depression, which can slow down breathing. Among COPD patients, this can lead to serious side effects like death.

Researchers warn this often is not communicated to doctors and put into clinical practice. They recommend several safety guidelines for the management of neuropathic pain with gabapentin drugs. And patients, especially COPD patients, should be warned about the potential for respiratory side effects.

“This study supports the warnings from regulatory agencies and highlights the importance of considering this potential risk when prescribing gabapentin and pregabalin to patients with COPD,” the researchers concluded.