This article pertains only to patients who take Lyrica (pregabalin) and are over age 65. If you don’t fall in that category, you have my permission to skip this one. The revelation reported here is not something I’ve seen because I didn’t have a lot of patients with chronic pain for whom I prescribed Lyrica. Rheumatologists and/or pain specialists would be more likely to see this since pregabalin and gabapentin (Neurontin) are drugs they prescribe every day for a host of chronic, non-cancer, pain syndromes.
Lyrica and gabapentin were studied extensively in “Medicare beneficiaries” aged 65-89 years who had chronic, non-cancer pain and no history of heart failure. They evaluated 246,237 patients on pregabalin (18,622 pts) and gabapentin (227,615). During the study period, 1470 patients were seen in the ER, or admitted to the hospital, for heart failure. Heart failure occurred in many more patients taking Lyrica than gabapentin. If the patients had some form of cardiovascular disease, their chance of heart failure was 1.48 times greater than in non-CVD patients.
This raised the suspicion that since Lyrica use is associated with new-onset heart failure, the possibility exists that it may “unmask” underlying, cardiovascular disease that was previously undetected. Like I mentioned, this is new information and not something I have seen in my patients. What it is about Lyrica that causes this is not known, but it begs doctors be vigilant for signs of heart failure in chronic pain patients on Lyrica, and to remember all drugs have potential harms. Not until enough patients have been on the drug for a long enough time, do adverse effects sometimes appear.
Reference : Brooks M, Common Painkiller Tied to Heart Failure Risk in Older Adults Medscape 2025 August 7.
