Gabapentin and pregabalin can suppress breathing, and that is not a boxed warning
The FDA added it to Warnings and Precautions in 2019. The distinction is worth being accurate about.
Top of the evidence hierarchy, independently funded. how we score evidence
In December 2019 the FDA warned that gabapentin and pregabalin can cause serious and potentially fatal respiratory depression. The risk concentrates in people with specific risk factors: taking opioids or other central nervous system depressants at the same time, existing respiratory impairment such as COPD, and older age.
Being precise about what the FDA actually did, because this gets misreported constantly: it required new Warnings and Precautions labelling, not a boxed warning. The current Neurontin label has no boxed warning at all. Anyone telling you gabapentin carries a black-box warning for breathing problems is wrong, and getting it wrong makes the real warning easier to dismiss.
The FDA also required manufacturers to run trials on abuse potential, particularly combined with opioids.
Worth asking
Does anything else I take count as a CNS depressant, and given my lungs and my age, what is the lowest dose that would work for me.
Source
Neurontin, Gralise, Horizant (gabapentin) and Lyrica, Lyrica CR (pregabalin): Drug Safety Communication — Serious Breathing Problems — U.S. Food and Drug Administration (2019)
Regulator or national health body
How this was scored
- Study design
- Regulatory safety determination
- Funding
- No external funding
- Published in
- Regulator or national health body
- Sample size
- not recorded
- Preregistered
- No
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 5, 2026. Last verified August 19, 2026.
Questions
How strong is the evidence behind this?
Resolv rates this source "gold standard". Top of the evidence hierarchy, independently funded. It scores 86 out of 100 on our published rubric. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Neurontin, Gralise, Horizant (gabapentin) and Lyrica, Lyrica CR (pregabalin): Drug Safety Communication — Serious Breathing Problems — U.S. Food and Drug Administration (2019). Published in: Regulator or national health body. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Regulatory safety determination. Funding: No external funding. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is gabapentinoid FDA approved?
Yes — this medication carries FDA approval. Approval is always for a specific indication, not for every use it is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.