Daily Doses of Gabapentinoids for Pain Management Among Opioid Users Aged Below and Above 65 years

Objective: Gabapentinoids (gabapentin and pregabalin) are increasingly prescribed for neuropathic pain, often as adjuncts to opioid therapy. However, limited evidence exists regarding their dosing patterns and duration of use across different age groups, particularly in older adults. To examine trends in daily doses and duration of gabapentinoid use among opioid users aged below and above 65 years.Methods: We conducted a retrospective cross-sectional study using prescription data from a tertiary hospital in Malaysia between 2010 and 2020. The analysis included all gabapentin and pregabalin prescriptions for patients aged ≥18 years with concurrent opioid use for pain management. Daily dose and days of supply were analyzed at the individual prescription level and stratified by age group (<65 and ≥65 years). Descriptive statistics and linear trend analyses were performed using Stata version 15.Results: The study included 6,734 prescriptions from 2,338 patients (mean age: 56.6 years; 54.3% female). Gabapentin comprised 91.3% of prescriptions. Among patients aged ≥65-years, mean daily gabapentin dose increased by 237.96% (P<0.001), compared to a 110.96% increase in younger patients (P<0.001). Pregabalin showed smaller, non-significant increases in dose across both groups. The duration of supply for gabapentin increased by 54.1% (P<0.001) in older adults and 76.8% (P<0.001) in younger adults. Pregabalin supply days increased by 171.7% (P=0.003) and 116.4% (P=0.002), respectively.Conclusion: Gabapentinoid use has risen in both dose and duration over time, particularly among older adults. These findings underscore the importance of age-informed prescribing and monitoring practices in opioid-treated populations.