- Gabapentin became the fifth most prescribed U.S. medication in 2024, a CDC analysis showed.
- From 2010 to 2024, prescriptions jumped from 79.5 to 177.6 per 1,000 people.
- Prescribing increased most for older adults and women.
Gabapentin prescribing rose sharply in recent years, with the generic drug becoming the fifth most dispensed product in retail pharmacies in 2024, a CDC analysis showed.
From 2010 to 2024, prescriptions jumped from 79.5 to 177.6 per 1,000 people, according to Gery Guy Jr., PhD, of the CDC National Center for Injury Prevention and Control, and co-authors.
The number of persons who received gabapentin soared from 5.8 million in 2010 to 15.5 million in 2024, Guy and colleagues reported in Annals of Internal Medicine. That represented an increase from 18.9 per 1,000 people in 2010 to 46.9 per 1,000 people in 2024.
Prescribing rates doubled between 2010 to 2016, but increased at a slower rate from 2016 to 2024.
"Although the rate of increase in gabapentin prescribing slowed after 2016, gabapentin prescribing is still increasing and was the fifth most prescribed medication in the United States in 2024, compared with the 10th most prescribed in 2017," Guy and colleagues wrote.
"Since 2016, some states have implemented policy changes, including enrolling gabapentin in prescription drug monitoring programs and reclassifying it as a schedule V controlled substance, which likely reduced gabapentin prescribing in those states," they added.
Gabapentin is approved for seizures and postherpetic neuralgia; gabapentin enacarbil is approved for restless legs syndrome. Despite limited indications, gabapentin and its cousin pregabalin are widely prescribed off-label for various other pain syndromes.
Common side effects of gabapentin include drowsiness, dizziness, blurry or double vision, and difficulty with coordination and concentration. In 2019, the FDA warned about serious breathing problems that may occur in patients using gabapentin or pregabalin who have respiratory risk factors. These factors included taking opioids or other drugs that depress the central nervous system, conditions like chronic obstructive pulmonary disease that reduce lung function, and older age.
"The increase in gabapentin prescribing from 2010 to 2024 reveals recent evidence of the continued uptick of gabapentin use in the United States," said Tasce Bongiovanni, MD, of the University of California San Francisco, who wasn't involved with the study.
"Careful attention to the use of gabapentin -- both new and persistent prescribing -- is crucial, especially in older adults who are also taking opioids due to potentially dangerous side effects when taken in combination," Bongiovanni told MedPage Today.
"Patients should be counseled on these side effects and careful consideration should be taken to weigh the risks of benefits of starting or continuing the medication," she added.
Guy and co-authors analyzed data from the IQVIA National Prescription Audit and Total Patient Tracker all-payer pharmaceutical databases, evaluating prescribing trends and the number of people dispensed gabapentin from 2010 to 2024. The IQVIA databases capture 94% of retail pharmacy-dispensed prescriptions in the U.S., they noted.
Women (57.1 per 1,000) and adults ages 65 and up (114.7 per 1,000) were dispensed gabapentin at higher rates in 2024 compared with 2016. Prescribing to older adults rose by 33.7% from 2016 to 2024 -- more than any other age group.
Primary care clinicians prescribed the most gabapentin in 2024, at 22.6 per 1,000 persons.
Notably, gabapentin prescribing among advanced practitioners (nurse practitioners and physician assistants) surged over the course of the study, from 2.5 per 1,000 persons in 20
10 to 19.5 per 1,000 persons in 2024. This may reflect expanded prescribing authorities in certain states, but warrants further study, Guy and colleagues noted.
Prescriptions dispensed outside of retail pharmacies (in hospitals or long-term care facilities, or through mail-order pharmacies) were not captured, the researchers acknowledged. Prescriber type was determined by IQVIA and clinical specialties for nurse practitioners and physician assistants was not available.
"This study highlights a slowed, but continued, increase in gabapentin dispensing from retail pharmacies in the United States," Guy and colleagues stated. "As gabapentin dispensing continues to increase, particularly among older populations, prescribing physicians and advanced practitioners should be alert to the potential adverse effects of gabapentin."
Disclosures
Bongiovanni had no disclosures.
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.