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DI-024 Off-label use of gabapentin and pregabalin in a tertiary hospital
  1. J González-Bueno1,
  2. E Calvo-Cidoncha2,
  3. T Desongles-Corrales1,
  4. MD Santos Rubio1,
  5. E Chamorro de Vega1,
  6. FJ Bautista-Paloma1
  1. 1Virgen Del Rocío Hospital, Pharmacy Department, Seville, Spain
  2. 2Virgen de Valme Hospital, Pharmacy Department, Seville, Spain


Background Gabapentin and pregabalin are two GABA analogues, example of an evergreening strategy. Both have been associated with a markedly off-label use.

Purpose To describe the extent and nature of the off-label use of gabapentin and pregabalin.

Material and methods Prospective observational study performed in a tertiary hospital. We included patients being treated with gabapentin or pregabalin at any time between June and August 2014. The variables collected were: sex, age, drug, therapeutic indication, dose and cost per patient-month (according to retail prices). These data were used to describe the rate and nature of the overall use and off-label use by drug. Data were collected through review of medical records and by electronic pharmacy refill records. Statistical analysis was performed using SPSS Statistics 20.0.

Results Sixty-five patients (54% male, mean age 60 ± 14 years) were included. Eighteen (28%) were being treated with gabapentin and 47 (28%) with pregabalin. The overall off-label use was 43% (28 patients), with no differences between the drugs (44% gabapentin and 43% pregabalin). The off-label use was related to the therapeutic indication (25 patients) or the dose (3 patients). The off-label indications for gabapentin were: central neuropathic pain (6), subacute or chronic low back pain (3), generalised anxiety disorder (3) and refractory visceral pain (1). The off-label indications for pregabalin were: subacute or chronic low back pain (6 patients), fibromyalgia (5), and essential tremor (1). The average cost per patient-month was €25 ± 11 for gabapentin and €156 ± 65 for pregabalin.

Conclusion Gabapentin and pregabalin are often prescribed for off-label use. Despite having failed to demonstrate clinically relevant differences over gabapentin, pregabalin holds a high prescription rate with consequent extra costs for the hospital, representing an area in which rational drug use could be promoted.


  1. Radley DC, Finkelstein SN, Stafford RS. Off-label prescribing among office-based physicians. Arch Intern Med 2006;166:1021–6

ReferenceNo conflict of interest.

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