其 他 安 全 警 示
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| Canada: Health Canada advises Canadians to exercise caution when taking gabapentin or pregabalin with opioids (English only) |
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Health Canada is advising Canadians about the increased risk of opioid overdose and serious side effects when taking gabapentin (e.g., Neurontin) or pregabalin (e.g., Lyrica) with an opioid.
Gabapentin is authorized to treat epilepsy and pregabalin is authorized to treat nerve pain. Both drugs belong to a class of drugs called gabapentinoids, which have been marketed in Canada since 1994.
Opioids are drugs that are used primarily to treat pain. They include both prescription and non-prescription medications such as codeine, fentanyl, morphine, oxycodone, hydromorphone, tramadol, tapentadol, hydrocodone, methadone and buprenorphine. Opioids may also be prescribed for other conditions, such as moderate to severe diarrhea, moderate to severe cough, and opioid use disorder. Increasingly, opioids such as fentanyl can also be found in illegal drugs, including heroin and cocaine. Consuming as little as a few grains of salt worth of fentanyl alone can be deadly.
When used with opioids, gabapentinoids increase the risk of opioid overdose. Serious side effects of using gabapentinoids and opioids at the same time include respiratory depression (slowed breathing), increased sedation (sleepiness), dizziness, fainting, and death. If patients suspect an overdose, call for emergency help, administer naloxone if they have it, and stay with the person. Naloxone is a fast-acting drug that can temporarily reverse the effects of an opioid overdose.
Patients are advised:
- Consult their healthcare practitioner if they currently use or have used gabapentinoids or opioids and are concerned about their health.
- Know the signs of an opioid overdose.
- Stay informed and consult their healthcare practitioner on what other drugs and substances can increase the risk of overdose when mixed with opioids. Other substances, such as benzodiazepines and alcohol, can also increase the risk of opioid overdose.
Please refer to the following website in Health Canada for details:
http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/../71003a-eng.php
In Hong Kong, there are 25 registered pharmaceutical products containing gabapentin, and 49 products containing pregabalin. All products are prescription-only medicines. So far, the Department of Health (DH) has received adverse drug reaction related to gabapentin (3 cases) and pregabalin (9 cases), but these cases are not related to drug interaction.
Related news on concomitant use of gabapentin and opioids was previously issued by the United Kingdom Medicines and Healthcare products Regulatory Agency, and was posted on the Drug Office website on 27 Oct 2017. Letters to inform local healthcare professionals were issued by the DH on the same day. In Dec 2017, the Registration Committee of the Pharmacy and Poisons Board discussed the matter, and decided that warnings on central nervous system depression, sedation and respiratory depression with the concomitant use of gabapentin and opioids should be included in gabapentin-containing products. In light of the above Health Canada’s announcement, letters to inform local healthcare professionals will be issued, and the DH will remain vigilant on safety update of the drugs issued by other overseas drug regulatory authorities.
Ends/Wednesday, Sep 18, 2019
Issued at HKT 17:00
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