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Paper Chase #5 - Off-Label Gabapentinoid Prescriptions in Hospitalized Patients

Steve Biederman, MD and Tom Robertson, MD
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To describe prescribing trends of gabapentinoids in hospitalized patients.

 

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Sarah N. -

Gabapentin is renally cleared and requires dose adjustments for CrCl < 60. I work primarily inpatient with post-operative patients with very tenuous renal function. In collaboration with our anesthesia colleagues, we frequently use gabapentin as a part of a multimodal pain regimen to reduce opioid demands in patients with poor pain tolerance and uptitrate as tolerated by both the kidneys and side effect profile. We then taper their pain regimen in clinic. In my limited clinical practice, I have seen this to be a beneficial approach. Evidence is definitely limited but I did find these recommendations from the American Pain Society to be interesting and may help some of the PC RAP listeners with acute postoperative pain management. https://www.jpain.org/article/S1526-5900(15)00995-5/pdf

Neda F., MD -

Thank you so much for sharing, Sarah!

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Primary Care RAP March 2020 Written Summary 1,010 KB - PDF

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