A case of gabapentin‐induced rhabdomyolysis requiring renal replacement therapy

Abstract

Gabapentin is commonly used for controlling convulsions, restless pain syndrome, and pain in diabetic neuropathy. Common side effects include dizziness, somnolence, ataxia, peripheral edema, and confusion; gabapentin-induced rhabdomyolysis is rarely reported. To date, the reported cases of gabapentin-induced rhabdomyolysis have been associated with patients with multiple underlying diseases and assuming multiple medicines for various reasons. In this report, we describe a case of gabapentin-induced rhabdomyolysis in a 32-year-old woman with no medical history. We also review related literature and discuss the possible mechanism and the association with other factors. This case shows that gabapentin can induce rhabdomyolysis in healthy patients and that clinicians must consider the possible association between gabapentin and rhabdomyolysis.

Rhabdomyolysis associated with newer-generation anti-seizure medications (ASMs): a real-world retrospective and pharmacovigilance study

“…We identified 26 case reports of rhabdomyolysis induced by newer-generation ASMs, with 26 patients included (10 males and 16 females) ( Kaufman and Choy, 2012 ; Gunathilake et al, 2013 ; Akiyama et al, 2014 ; Isaacson et al, 2014 ; Spengler et al, 2014 ; Incecik et al, 2016 ; Karaoulanis et al, 2016 ; Kato et al, 2016 ; Ramon et al, 2016 ; Singh et al, 2016 ; Choi et al, 2017 ; Coupal et al, 2017 ; Di Lorenzo and Li, 2017 ; Kubota et al, 2017 ; Shahbaz et al, 2017 ; Matsudaira et al, 2018 ; Mena-Martin et al, 2018 ; Rastogi et al, 2018 ; Rota et al, 2018 ; Qiu et al, 2019 ; Thomas et al, 2019 ; Aslan et al, 2020 ; Ghosh et al, 2020 ; Moinuddin, 2020 ; Alshehabi et al, 2022 ; Boucher et al, 2022 ) ( Table 3 ). All the studies were published in English and originated from the following regions: 10 cases from South America, 10 cases from Asia, 5 cases from Europe and 1 case from Oceania.…”

Mining and visualizing high-order directional drug interaction effects using the FAERS database

“…Thus, it is likely that interactions in pharmacodynamic mechanisms also increase risk of myopathy. For instance, each of the drugs in the top 4way combination (fentanyl, gabapentin, levofloxacin, and zolendronate) have each individually been associated with myopathy [12][13][14][15][16][17][18].…”

A case of gabapentin overdose induced rhabdomyolysis requiring renal replacement therapy

“…Gabapentin functions as a γ‐aminobutyric acid (GABA)‐mimetic agent, binding to the alpha‐2‐delta subunit of the voltage‐gated calcium channels . Gabapentin was originally approved by the US Food and Drug Administration (FDA) in 1993 for epilepsy and later, postherpetic neuralgia .…”

“…Gabapentin functions as a γ-aminobutyric acid (GABA)mimetic agent, binding to the alpha-2-delta subunit of the voltage-gated calcium channels. 2 Gabapentin was originally approved by the US Food and Drug Administration (FDA) in 1993 for epilepsy and later, postherpetic neuralgia. 1 Recently, gabapentin has been increasingly used in some off-label indications as a desired alternative of opioids for pain management, 1,3 probably due to its relative low rate of adverse effect and low cost.…”

“…Seven reported cases of gabapentin-induced myopathy in PubMed database but only five cases are rhabdomyolysis, see Table2. 2,[14][15][16][17] Lipson et al reported two cases of myopathy in patients receiving hemodialysis developed neuromuscular symptoms and a lower level of elevation of creatine kinase after starting gabapentin therapy with longer symptoms onset (2 weeks and 6 weeks, respectively). Patient is already on hemodialysis, so it is less likely it is acute rhabdomyolysis per se.…”