Gabapentin Rises to Fifth Most Prescribed Medication in Community Pharmacy
Since 2016, the rate of gabapentin prescribing slowed but is still increasing, especially for women and older adults.
The rate of gabapentin prescribing has slowed since 2016; however, prescribing is still increasing, and gabapentin became the fifth most prescribed medication in the United States in 2024, which is up from tenth in 2017, according to authors of a letter to Annals of Internal Medicine.1
Since 2016, the rate of gabapentin prescribing slowed but is still increasing, especially for women and older adults. | Image Credit: ColleenMichaels - stock.adobe.com
“Gabapentin dispensing was highest and continues to increase among older adults, which may reflect increases in off-label prescribing for pain syndromes and other comorbidities common among older adults,” the study authors said.1
Gabapentin is an anticonvulsant that has been approved by the FDA to help control partial seizures as treatment of epilepsy. It is also used to manage postherpetic neuralgia, which occurs after shingles. It has also been widely used for off-label indications, often as an alternative to opioid therapy. From 2012 to 2016, prescribing increased 64%, and by 2001, approximately 83% of gabapentin prescriptions were for nonseizure conditions, according to authors of a paper in Substance Abuse: Research and Treatment. Although gabapentin alone is infrequently involved in fatal overdoses, it has been noted to cause serious breathing difficulties for patients with respiratory conditions and patients who use it in combination with opioids.1-3
Further, prescribers, pharmacists, and patients should be aware of adverse effects, which can include clumsiness or unsteadiness, continuous and uncontrolled eye movements, chest pains, chills, cough, depression, fever, loss of memory, sore throat, ulcers, sores, or white spots on the lips or in the mouth, and unusual tiredness or weakness.2
In the current review, investigators examined gabapentin dispensing from retail pharmacies from 2010 to 2025. Data from the IQVIA National Prescription Audit and Total Patient Tracker were used, which account for approximately 94% of all retail pharmacy-dispensed prescriptions. Prescriptions written by veterinarians were excluded, according to the authors. Investigators examined the trends in dispensed gabapentin prescriptions as well as the number of unique persons dispensed gabapentin. Prescriber type and patient characteristics were also analyzed.1
Investigators found that gabapentin prescriptions increased from 79 per 1000 persons in 2010 to 177.6 per 1000 persons in 2024, according to the review authors. For people dispensed gabapentin from 2010 to 2024, investigators reported 18.9 per 1000 persons and 46.9 per 1000 persons, respectively. From 2010 to 2016, prescriptions increased from 79.5 to 170.6 and from 18.9 to 37.8 people, respectively. From 2016 to 2014, the rates increased slower, from 170.6 to 177.6 for prescriptions and from 37.8 to 46.9 for people, respectively.1
Patients who were female and those 65 years and older were dispensed the drug at higher rates at 57.1 and 114.5 per 1000 persons in 2024, respectively. Prescribing to older adults also increased more, from 85.8 to 114.7 per 1000 persons from 2016 to 2024, respectively. The majority of prescriptions were prescribed by primary care physicians; however, there was a substantial increase among advanced practitioners from 2010 to 2024, from 2.5 per 1000 persons to 19.5 per 1000 persons.1
Increased prescribing by nurse practitioners and physician assistants may reflect the increasing numbers of advanced practitioners or expanded prescribing authorities in certain states,” the study authors said. “However, reasons for changes in dispensing by prescriber type are unclear and warrant further study.”
READ MORE: Nonopioid Pain Management Resource Center
Are you ready to elevate your pharmacy practice? Sign up today for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips straight to your inbox.
REFERENCES
1. Strahan AR, Rikard SM, Schmit K, Zhang K, Guy GP Jr. Trends in dispensed gabapentin prescriptions in the United States, 2010 to 2024. Ann Intern Med. 2025. doi:10.7326/ANNALS-25-01750
2. Mayo Clinic. Gabapentin (oral route). Accessed September 29, 2025. https://www.mayoclinic.org/drugs-supplements/gabapentin-oral-route/description/drg-20064011
3. Peckham AM, Evoy KE, Ochs L, Covvey JR. Gabapentin for Off-Label Use: Evidence-Based or Cause for Concern?. Subst Abuse. 2018;12:1178221818801311. Published 2018 Sep 23. doi:10.1177/1178221818801311
Newsletter
Pharmacy practice is always changing. Stay ahead of the curve with the Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips.
