According to new research conducted by the Ontario Drug Policy Research Network, patients taking opioid pain medications in conjunction with the anti-epileptic drug gabapentin have a 49% greater risk for opioid related death than those treated with opioids only.
“Opioids can increase the amount of gabapentin absorbed, leading to a higher risk of sedation and fatal overdoses.” – Dr. David Silver
A Canadian research team led by Tara Gomes, PhD, MHSc used administrative databases to examine the opioid related deaths of 1,256 patients. Among this population, researchers found that the combination of opioids and gabapentin was associated with a 49% increased in opioid related death over an opioid prescription alone. Researchers notes that this risk was still present after making adjustments for confounding factors such as dose, other medications and chronic illness.
Additionally, researchers analyzed the gabapentin dose among this patient population and categorized dosages into low (<900mg daily), moderate (900-,1799 mg daily) and high (>1,800 mg daily) to determine the relationship between dose and mortality rates. They found that moderate or high dosages of gabapentin were associated with close to a 60% increased risk for opioid related death over exposure to opioids alone.
“Our finding that even moderate doses of gabapentin increased risk of opioid related death was important, and the fact that this increases to a twofold higher risk among people getting higher doses is concerning,” remarked principal investigator Dr. Tara Gomes.
The exact nature of the increased risk of death in patients taking a combination of opioids and gabapentin is not clear, “It is very possible that the pharmacokinetics of these two products is at the root of the problem,” explains rheumatologist and pain management expert, Dr. David Silver. According to Dr. Silver, “Opioids can interact with gabapentin in such a way that allows more gabapentin to be absorbed, leading to higher risk of sedation and respiratory depression which is ultimately the cause of fatal overdoses.”
You can read the entire study here.
Marcus has over a decade of experience in the medical foods and dietary supplement industry and currently serves as Managing Director for Physician Therapeutics.