What are the typical adverse effects of gabapentin and pregabalin to monitor in older adults?

• A. Hypertension and tachycardia
• B. Hyperactivity
• C. Rash
• D. Dizziness, somnolence, edema; caution with renal impairment.

Answer: (D)

Gabapentinoids commonly produce central nervous system–related side effects and fluid retention, especially in older adults. Dizziness and somnolence reflect CNS depressant effects, which can impair balance, alertness, and increase the risk of falls in the elderly. Peripheral edema is another well-recognized adverse effect, potentially adding to mobility issues or heart failure symptoms in older patients. Because these drugs are mainly eliminated by the kidneys, reduced renal function with aging leads to slower clearance, higher drug exposure, and a greater likelihood of sedation, dizziness, and edema. Therefore, monitoring for these effects and adjusting dose based on renal function is essential. The other options do not capture the typical adverse effects seen with these medications in this population.