Can gabapentin (Gabapentin) be added as an adjuvant for the management of cancer-related pain?

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Last updated: February 11, 2025 • View editorial policy

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From the Guidelines

Yes, gabapentin can be added as an adjuvant for the management of cancer-related pain.

Rationale

  • The use of gabapentin as an adjuvant analgesic for cancer-related pain is supported by several studies, including a systematic review and randomized controlled trials (RCTs) 1.
  • Gabapentin has been shown to be effective in reducing neuropathic pain in patients with cancer, particularly when used in combination with opioids 1.
  • The National Comprehensive Cancer Network (NCCN) guidelines recommend the use of adjuvant analgesics, including gabapentin, for the treatment of neuropathic cancer pain 1.
  • Gabapentin has been studied primarily in non-cancer neuropathy syndromes, but its effectiveness in cancer-related pain has been demonstrated in several studies 1.

Key Points

  • Gabapentin is an anticonvulsant that can be used to treat neuropathic pain in patients with cancer.
  • The medication can be used in combination with opioids to enhance analgesia and reduce opioid requirements.
  • The NCCN guidelines recommend the use of gabapentin as an adjuvant analgesic for the treatment of neuropathic cancer pain.
  • Gabapentin has been shown to be effective in reducing neuropathic pain in patients with cancer, particularly when used in combination with opioids.

Important Considerations

  • The use of gabapentin should be individualized and based on the patient's specific needs and medical history.
  • The medication should be used in combination with other analgesics, such as opioids, to enhance pain relief.
  • Patients should be monitored closely for adverse effects, such as dizziness, drowsiness, and nausea, and the dose should be adjusted accordingly.
  • Gabapentin can be used in combination with other adjuvant analgesics, such as antidepressants and corticosteroids, to enhance pain relief 1.

From the Research

Gabapentin as an Adjuvant for Cancer-Related Pain

  • Gabapentin can be added as an adjuvant for the management of cancer-related pain, particularly neuropathic cancer pain, as it has been shown to provide better relief of neuropathic pain in cancer patients than opioid monotherapy 2.
  • The combination of gabapentin and an opioid may represent a potential first-line regimen for the management of pain in cancer patients, with studies demonstrating reduced pain and analgesic use 2, 3.
  • Gabapentin has been found to be effective in treating cancer-related neuropathic pain, with significant reductions in worst, average, and current pain scores, as well as improvements in daily living activities 4.

Efficacy of Gabapentin in Neuropathic Cancer Pain

  • A meta-analysis of seven studies found that gabapentin combined with opioids effectively alleviated neuropathic cancer pain compared to opioids alone, with a significant reduction in pain intensity 3.
  • Another study found that gabapentin added to an opioid provided better relief of neuropathic pain in cancer patients than opioid monotherapy, with an earlier significant decrease in allodynia and a lower rate of side effects 2.
  • A prospective open-label trial found that gabapentin statistically reduced worst, least, and average numerical rating scale scores in Japanese patients with neuropathic cancer pain, although the decrease in pain score was of minimal clinical benefit 5.

Use of Gabapentin in Cancer Pain and Perioperative Pain

  • A literature review found that gabapentin has significant benefit in neuropathic and non-neuropathic pain associated with the perioperative period and cancer, with a favorable side effect profile 6.
  • Gabapentin has been used as an adjunct or primary therapy in non-neuropathic pain, including perioperative and cancer pain, with multiple well-designed clinical trials demonstrating reduced pain and analgesic use 6.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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