Pregabalin safety alert

A large study ties pregabalin to higher heart failure risk in older adults, prompting calls for tighter prescribing.

Pregabalin linked to heart failure risk in elderly

A major observational study led by Columbia University Irving Medical Center analyzed Medicare records for 246,237 adults aged 65 to 89 over four years. The researchers compared users of pregabalin with nonusers and found the drug was linked to a higher rate of hospitalizations for heart failure among seniors who did not have heart failure at the start. The study recorded 1,470 hospitalizations for heart failure during the period and estimated about six additional cases per 1,000 people per year among pregabalin users. None of the participants had a prior heart failure diagnosis at baseline. Regulators and health systems have long warned about cardiovascular risks with pregabalin, and this study adds weight to those cautions.

Pregabalin is prescribed for epilepsy and is sometimes used for neuropathic pain or anxiety. The NHS notes it is mainly for adults and advises caution for people over 65. Side effects can include headaches, diarrhea, nausea, blurred vision, memory problems, and in rare cases anaphylaxis. Health agencies emphasize careful patient selection and monitoring when pregabalin is considered, especially in older adults with a history of heart disease.

The findings highlight the delicate balance doctors face when treating chronic pain in later life. Pain relief matters, but heart health matters too. Because this is an observational study, it shows associations rather than proof of cause. Still, the signal is strong enough to push clinicians to review a patient’s heart history before prescribing and to consider safer alternatives when possible.

Policy and practice could shift as a result. Regulators may strengthen warnings, and health systems may require more rigorous risk assessments before starting pregabalin, particularly for patients with heart disease. The results also point to the need for better non drug therapies and closer monitoring. In the end, the message is clear: safer prescribing saves lives.

Highlights

The safest path is careful patient screening and clearer guidance for clinicians.