pts on Gabapentin/Lyrica

[PinchandBurn]

Any of you with patients on Gabapentin/Lyrica for a long period of time (>1year)?

Any 'labs' or anything you guys are checking? Any long term sequalae known about, assuming they have normal renal function?

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[ghost dog]

Any of you with patients on Gabapentin/Lyrica for a long period of time (>1year)?

Any 'labs' or anything you guys are checking? Any long term sequalae known about, assuming they have normal renal function?

Just curious : are you asking for a specific reason : case report / specific pt ?

Looking up Lyrica on Epocrates, it states that thrombocytopenia and rhabdo are possibilities. I've had a lot of pts on this med and never seen it. Epocrates recommends a screening creatinine prior to starting Lyrica.

Because Lyrica can cause edema, I am cautious using this med in patients with CHF.

Being a cautious doc, you could do screening bloods for the above conditions every 6 months thereafter.

Possibilites with Gabapentin cited are: leukopenia, thrombocytopenia, eosinophilia, withdrawal seizures and ARF. Same screening blds as with Lyrica.

 

[clubdeac]

Anyone anecdotally see any differences in the side effect profiles and patient tolerance of neurontin vs lyrica

 

[ghost dog]

Anyone anecdotally see any differences in the side effect profiles and patient tolerance of neurontin vs lyrica

I haven't seen any differences.

If there is a problem, pts will complain about: fatigue , vertigo and weight gain. I find that some FM pts do get benefit from the above , although tolerance can be a problem. Having said that, this population is notorious for being intolerant to pretty much any med you give them ( aside from mayhaps opioids).

Derailing this topic, I have seen 1 (one) FM pt do well on strong opioids ( i.e. from a functional perspective : grades improved in college, etc,). I should note that she had no psychopathology to speak of, which made her quite an unusual fibro pt. Needless to say, I don't script this class of meds anymore for FM.

 

[Tenesma]

labs?? neither gabapentin/lyrica have any hepatic metabolism that I am aware of... I do adjust dosing for hemo-dialysis pts...

 

[PinchandBurn]

labs?? neither gabapentin/lyrica have any hepatic metabolism that I am aware of... I do adjust dosing for hemo-dialysis pts...

thats all i do to, give less to renal patients.

Otherwise, there's no 'labs' i'm aware of...

 

[PMR 4 MSK]

Any of you with patients on Gabapentin/Lyrica for a long period of time (>1year)?

Any 'labs' or anything you guys are checking? Any long term sequalae known about, assuming they have normal renal function?

1) Yes
2) No
3) No

 

[clubdeac]

Anybody see or suspect any patients of abusing Neurontin. I know it sounds crazy but I inherited a patient who he just got a ton of Gabapentin then said it was stolen. Went to the ER to get more and is now asking me for even more. Can this stuff be abused?

 

[Agast]

Anybody see or suspect any patients of abusing Neurontin. I know it sounds crazy but I inherited a patient who he just got a ton of Gabapentin then said it was stolen. Went to the ER to get more and is now asking me for even more. Can this stuff be abused?

Maybe they're diverting it to a family member/friend who doesn't have health insurance and can't get their own? Either that or they reallllly like being drowsy *shrug*

 

[Ligament]

I have lots of patients on these meds long term, never check labs unless in known renal failure I just dose much less to start and titrate to effect but do not order labs for this (I know they are in renal failure, that is enough info). I am not aware of concerning long term sequelae, just short term sequelae (edema, dizzyness, weight gain, stupidity) which manifest within days to months in 99% of cases that develop sequelae.

I'm not saying my way is the best, but having used these meds for many years I have few concerns.

 

[Cytarabine]

Anybody see or suspect any patients of abusing Neurontin. I know it sounds crazy but I inherited a patient who he just got a ton of Gabapentin then said it was stolen. Went to the ER to get more and is now asking me for even more. Can this stuff be abused?

https://www.erowid.org/experiences/subs/exp_Pharms_Gabapentin.shtml

Looks like it. It isn't one I've heard anything about before searching for it though

 

[pastafan]

https://www.erowid.org/experiences/subs/exp_Pharms_Gabapentin.shtml

Looks like it. It isn't one I've heard anything about before searching for it though

New patient last week that had just finished inpatient rehab. She was abusing Lyrica, taking 800 mg several times a day, among other substances.

 

[AGSIII]

Working in the treatment industry, I have definitely encountered patients who abuse these drugs.

 

[clubdeac]

Wanted to resurrect this thread. Received a note from PCP stating patient's AST was 10x normal which he attributed to the Lyrica I was prescribing. I've never heard of Lyrica causing hepatotoxicity. Anyone ever heard of this? I think he's fishin in the wrong pond

 

[Pain_doc]

not aware of lyrica causing elevated AST. Its excreted essentially unchanged in the urine.

 

[neutro]

i get baseline Creatinine on these patients and check q6mth to q12 mth.

 

[lobelsteve]

Statin, muscle relaxant (other than Robaxin)