Risk of Pregabalin‐Induced Hypoglycemia: Analysis of the Japanese Adverse Drug Event Report Database

Abstract

Pregabalin is a first-line treatment option for neuropathic pain. Recently, some cases of pregabalin-induced hypoglycemia have been reported, which can complicate the treatment of neuropathic pain and worsen patient outcomes. Therefore, a better understanding of the clinical condition of patients with pregabalin-induced hypoglycemia is desirable. In this study, we evaluated the risk of hypoglycemia in patients administered pregabalin, using the Japanese Adverse Drug Event Report database. All patients on pregabalin not taking any antidiabetic agents were screened from April 2004 to July 2020, and data on adverse events related to hypoglycemia, sex, age, weight, and the presence of chronic kidney disease were collected. Gabapentin and duloxetine, which are usually indicated for neuropathic pain, were used for comparison. Among 242 275 patients, 4287 were administered pregabalin, which included 37 patients who reported hypoglycemic incidents. Disproportionality of hypoglycemia was observed in patients administered pregabalin (reporting odds ratio, 2.25; 95%CI, 1.16-3.13; P < .01), whereas this was not the case in patients taking gabapentin and duloxetine. Multivariate logistic regression showed that hypoglycemia in patients on pregabalin was associated with age ≥70 years (odds ratio, 2.76; 95%CI, 1.29-5.91; P < 0.01) and weight <40 kg (odds ratio, 2.97; 95%CI, 1.32-6.71; P < 0.01). These findings suggest that pregabalin may be associated with a higher risk of hypoglycemia, especially in elderly individuals with low body weight. Health care providers may need to be aware of pregabalin-induced hypoglycemia in patients with these risk factors during therapy.

Study of Acute Pregabalin Intoxication in Patients Admitted to Poison Control Center Ain Shams University Hospitals and its Pathological Effect on Rat Brain: Clinical and Experimental Study

“…Hypoglycemia was observed in 13% of studied patients. The mechanism of hypoglycemia is not completely understood but it is thought to be related to the secretion of insulin through the action of PGB on the α2δ subunit of voltage-sensitive Ca2+ channels in the β cells of the pancreas (Yamada et al, 2022).…”

Frequency of Hypoglycemia Assessed by Continuous Glucose Monitoring in Advanced CKD

“…Age, alcohol consumption, smoking, medical history, and medications were retrieved from the electronic medical records. The use of insulin, oral glucose-lowering medications, antihypertensive drugs, and other glucose-lowering drugs (e.g., cibenzoline succinate, pregabalin, and some antipsychotic drugs) [21][22][23] was categorized as yes or no. Body mass index (BMI) was calculated using the following formula: weight/height 2 (kg/m 2 ).…”