Do you guys routinely check BMP/Renal Function on patients on Gabapentin?

[Blitz2006]

Just wondering, since some of the pain docs I work with don't.

Is it necessary? Good practice, or just a waste of time?

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[deleted185747]

I don't. Either they pee or they are on dialysis. If multiple medical comorbidities or advanced age then I'll start really low, maybe 100 qhs or bid to start rather then check labs

 

[Ligament]

Never, ever.

 

[lobelsteve]

I work in 20 doc group as only pain guy. 80% of my patients have PCP and other specialists in our office, use our lab, same EHR.

 

[neutro]

i do, but its available to me through labs that PCP order for the patient.
I check it not only for gabapentin, but also NSAIDs and if I am considering initiating opioids. If elevated, will stay away from Morphine formulations.

 

[Blitz2006]

i do, but its available to me through labs that PCP order for the patient.
I check it not only for gabapentin, but also NSAIDs and if I am considering initiating opioids. If elevated, will stay away from Morphine formulations.

Thats another question I have. I come from psych, where we are OCD with checking kidneys on patients on Lithium.

But for NSAIDs, how long do you keep them on NSAID before you decide to stop the med/switch to opioid or check kidneys?

 

[Ducttape]

Thats another question I have. I come from psych, where we are OCD with checking kidneys on patients on Lithium.

But for NSAIDs, how long do you keep them on NSAID before you decide to stop the med/switch to opioid or check kidneys?

huh?

if someone fails NSAID (I give 4 weeks max), then I stop. there is no direct correlation with initiation of opioid therapy.

 

[Blitz2006]

Yeah sorry, that's what I meant. Although I have seen pain docs switch from NSAIDs to tramadol... Sigh.

But 4 weeks for NSAIDs good to know.

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