‘Coffin tablets’ – risks and perspective

Sir, – While the association of the drug pregabalin with positive toxicology testing in about 6 per cent of deaths is noteworthy, it is probably worth pointing out that this has little to do with the term “coffin tablets” (“‘Coffin tablet’: Renewed calls for prescription drug feared to be ‘new OxyContin’ to be reclassified”, News, February 26th). In particular as the drug is so widely prescribed, and that general anxiety is often a factor in this decision, it is wise to keep both the risks and slang terminology in perspective.

Writing in the British Journal of Clinical Pharmacology in 2020, Isoardi and colleagues reported on 488 cases of pregabalin poisoning presenting to hospital. All patients were discharged home with an average stay of about 16 hours. This included a large number of mixed overdoses, or cases of polypharmacy. The authors concluded that “pregabalin does not cause severe toxicity, but rather mild sedation and uncommonly, seizures”. It may reassure many and clarify matters to say that the term “coffin tablets” refers to a common formulation where the tablets are brown coloured and elongated in shape, wider at one end and tapering toward the other.

That many patients test positive for it is not a reason to attribute their death to this widely used medication. As with any tablet, it should be taken as prescribed. Buying it from people on the street is not to be recommended, clearly. – Yours, etc,

BRIAN O’BRIEN,