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Gabapentinoid opioid respiratory depression — GPhC CRA MCQ

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HardAdverse Drug Reactions and SafetyGabapentinoid opioid respiratory depressionGPhC CRA

A 69-year-old woman taking gabapentin 600mg three times daily and diazepam 5mg at night asks for codeine linctus for a cough. She has COPD and oxygen saturations are usually 92%. What is the most appropriate alternative?

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Correct answer: C — Avoid opioid cough medicine and refer for assessment of cough and sedation risk

Gabapentin, benzodiazepines and opioids can have additive CNS and respiratory depressant effects. COPD and baseline low oxygen saturation increase the risk of harm. Codeine linctus is not appropriate without clinical assessment, and cough in COPD may need review for infection or exacerbation. Safer symptomatic measures or referral should be considered.

Reference: BNF; MHRA Drug Safety Update