Gabapentinoid to Loop Diuretic Prescribing Cascade: A Systematic Review and Meta-Analysis of Observational Studies

Introduction. Gabapentinoid-induced peripheral edema may be misinterpreted as a new condition and treated with a loop diuretic, creating a prescribing cascade. Objective. To synthesize evidence on the gabapentinoid-to-loop diuretic prescribing cascade in adults: its magnitude, dose- and drug-related gradients, timing, and downstream harms. Methods. We searched MEDLINE, Embase, PubMed, and Web of Science to 23 April 2026 (PROSPERO CRD420261379968) for studies of loop diuretic initiation after gabapentinoid initiation and assessed risk of bias with ROBINS-I. Findings were synthesized by study de

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