Common painkiller linked to deadly heart failure in older people
A widely prescribed drug for nerve pain, anxiety and epilepsy has been linked to a significantly higher risk of heart failure, prompting calls for doctors to be more cautious when offering it to certain patients.
Pregabalin, available on prescription in the UK, was associated with a 48 percent increased risk of developing heart failure, according to a major new study. The risk was even greater among those with an existing history of heart disease, rising to 85 percent compared with patients prescribed gabapentin, a similar medication used for nerve pain.
The research, led by Columbia University Irving Medical Centre, examined the records of 246,237 Medicare patients aged between 65 and 89 over a four-year period. All participants had chronic non-cancer pain lasting longer than 12 weeks and none had previously been diagnosed with heart failure.
Heart failure occurs when the heart is unable to pump enough blood to meet the body's needs. While it can affect people at any age, it becomes more common as people grow older due to natural weakening and stiffening of the heart muscle.
During the study period, 1470 participants were admitted to hospital with heart failure. Researchers calculated that for every 1000 people taking pregabalin, there were around six additional cases each year compared with those not on the drug.
Dr Elizabeth Park, who led the study, said the findings supported the European Medicines Agency's current advice for doctors to be cautious when prescribing pregabalin to older adults with heart disease.
'Doctors should consider the cardiovascular risks of pregabalin, particularly for older or vulnerable patients,' the researchers said in their conclusion.
Pregabalin works by altering the way nerves send messages to the brain and is often used when traditional painkillers fail to relieve nerve pain. While generally considered safe under medical supervision, the drug can cause side effects including headaches, diarrhoea, nausea, blurred vision and memory problems.
In rare instances, pregabalin can trigger a severe allergic reaction known as anaphylaxis.
The NHS advises that pregabalin is only suitable for adults and may not be appropriate for people over 65. It should not be given to children under 18.
Doctors are advised to check whether patients have ever had an allergic reaction to pregabalin or any other medication, a history of substance misuse, or are pregnant or breastfeeding before prescribing the drug.
People on a controlled sodium diet, or those with kidney problems, are also advised to consult their doctor, as some liquid formulations contain sodium.
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Patients with breathing difficulties should also inform their healthcare provider before starting treatment.
Although there is no cure for heart failure, recognising symptoms early can help slow its progression and improve quality of life.
Common signs include shortness of breath during activity or when lying down, fatigue, and swelling in the legs, ankles and feet. Other symptoms can include a persistent cough, rapid or irregular heartbeat, dizziness and fainting.
Experts say prevention is key to reducing the likelihood of heart failure. Maintaining a healthy weight, staying physically active, eating a balanced diet, avoiding smoking, and controlling conditions such as high blood pressure, high cholesterol and diabetes can all help lower the risk.
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