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Nwankwo A, Koyyalagunta D, Huh B, D'Souza RS, Javed S. A comprehensive review of the typical and atypical side effects of gabapentin. Pain Pract 2024. [PMID: 38949515 DOI: 10.1111/papr.13400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/18/2024] [Accepted: 06/19/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Gabapentin, a widely prescribed medication for various neuropathic pain conditions, has demonstrated efficacy in managing diverse neurological disorders. While conventional side effects are well-documented, a growing body of evidence suggests the existence of atypical side effects, necessitating comprehensive exploration. This paper aims to systematically review and summarize the literature on the atypical side effects of gabapentin, shedding light on manifestations beyond the conventional spectrum. METHODS A systematic review was conducted, encompassing peer-reviewed articles published up to the knowledge cutoff date in November 2023. Databases, specifically PubMed, were searched for relevant studies, focusing on atypical side effects such as myoclonus, ataxia, pediatric aggression, respiratory depression, pneumonia, pregnancy complications, sleep interference, encephalopathy, peripheral edema, suicidal ideation, dyskinesia, anorgasmia, and myopathy. Inclusion criteria comprised studies with a focus on gabapentin-related atypical side effects, published in recognized journals and involving human subjects. RESULTS The review identified a spectrum of atypical side effects associated with gabapentin use, ranging from neurological manifestations like myoclonus and ataxia to behavioral changes such as pediatric aggression and suicidal ideation. Additionally, respiratory complications, pregnancy-related issues, sleep disturbances, and rare complications like encephalopathy and myopathy were observed. Literature synthesis provided insights into the incidence, clinical presentation, and potential mechanisms underlying these atypical side effects. CONCLUSION This comprehensive review highlights the diverse range of atypical side effects associated with gabapentin use, expanding beyond conventional knowledge. Healthcare practitioners must be cognizant of these manifestations, recognizing their potential impact on patient well-being. As clinical decision-making relies on a thorough understanding of a medication's side effect profile, this review contributes to enhancing awareness and fostering informed practices in the prescription and management of gabapentin. Further research is warranted to elucidate the mechanisms and risk factors associated with these atypical side effects, refining our understanding of gabapentin's safety profile.
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Affiliation(s)
| | | | - Billy Huh
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Saba Javed
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Wahyuni I, Aulifa DL, Rosdianto AM, Levita J. The pharmacology activities of Angelica keiskei Koidzumi and its efficacy and safety in humans. Heliyon 2024; 10:e24119. [PMID: 38357325 PMCID: PMC10865877 DOI: 10.1016/j.heliyon.2024.e24119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 02/16/2024] Open
Abstract
Chronic exposure to elevated levels of pro-oxidant factors may cause structural failings at the mitochondrial DNA level and alteration of antioxidant enzymes (glutathione peroxidase, catalase, and superoxide dismutase). Oxidative stress is an imbalance between the capacity of endogenous non-enzymatic antioxidants (glutathione, alpha-lipoic acid, uric acid, ferritin, metallothionein, melatonin, and bilirubin) and the occurrence of pro-oxidant factors which may lead to the pathogenesis of various diseases that affects the kidneys, pancreas, central nervous system, and cardiovascular system. Therefore, the utilization of medicinal plants with antioxidant activity, e.g., Angelica keiskei Koidzumi which contains chalcones, is interesting to be explored. Chalcones exhibit direct and indirect antioxidant activity and prevent oxidative stress by decreasing ROS, RNS, and superoxide production. In this review, we discuss the pharmacology activities of A. keiskei Koidzumi and its efficacy in humans. The articles were explored on PubMed and Google Scholar databases and based on the titles and abstracts related to the topic of interest, and 55 articles were selected. Two main chalcones of this plant, 4-hydroxyderricin and xanthoangelol, have been reported for their various pharmacology activities. The efficacy of A. keiskei was confirmed in anti-obesity, hepatoprotective, anti-diabetes mellitus, and increasing plasma antioxidants in patients with metabolic syndrome. A keiskei is safe as proven by only mild or no adverse events reported, thus it is prospective to be further developed as an antioxidant nutraceutical.
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Affiliation(s)
- Ika Wahyuni
- Master Program in Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, 45363, West Java, Indonesia
- Faculty of Health, Universitas Nahdlatul Ulama, Mataram, West Nusa Tenggara, Indonesia
| | - Diah Lia Aulifa
- Department of Pharmaceutical Analysis and Medicinal Chemistry, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, 45363, Indonesia
| | - Aziiz Mardanarian Rosdianto
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Veterinary Medicine Study Program, Faculty of Medicine, Universitas Padjadjaran, Sumedang, 45363, Indonesia
| | - Jutti Levita
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, 45363, Indonesia
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3
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Xie S, Xie M, Shen Y, Cheng D. Gabapentin for chronic refractory cough: A system review and meta-analysis. Heliyon 2023; 9:e15579. [PMID: 37131438 PMCID: PMC10149207 DOI: 10.1016/j.heliyon.2023.e15579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 05/04/2023] Open
Abstract
Objective To evaluate the efficacy and safety of gabapentin in the treatment of chronic refractory cough by Meta-Analysis. Methods Literatures were retrieved from PubMed, Embase (OvidIP), Cochrane Library, CNKI, VIP, Wanfang Database and China Biomedical Management System and eligible prospective studies were screened. Data were extracted and analyzed by using RevMan 5.4.1 software. Results Six articles (2 RCTs and 4 prospective studies) with 536 participants were finally included. Meta-analysis showed that gabapentin was better than placebo in cough-specific quality of life (LCQ score, MD = 4.02, 95%CI [3.26,4,78], Z = 10.34, P < 0.00001), cough severity (VAS score, MD = -29.36, 95% CI (-39.46, -19.26), Z = 5.7, P < 0.00001), cough frequency (MD = -29.87, 95% CI [- 43.84, -15.91], Z = 4.19, P < 0.0001) and therapeutic efficacy (RR = 1.37,95%CI [1.13,1.65], Z = 3.27, P = 0.001), and equal in safety (RR = 1.32,95%CI [0.47,3.7], Z = 0.53, P = 0.59). Gabapentin was similar to other neuromodulators in therapeutic efficacy (RR = 1.07,95%CI [0.87,1.32], Z = 0.64, P = 0.52), but its safety was better. Conclusion Gabapentin is effective in the treatment of chronic refractory cough in both subjective and objective evaluations, and its safety is better than other neuromodulators.
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Affiliation(s)
- Sheng Xie
- Department of Pulmonary and Critical Care Medicine, Chengdu First People's Hospital, Sichuan, China
| | - Meiling Xie
- Department of Traditional Chinese Medicine, Sichuan Electric Power Hospital, Sichuan, China
| | - Yongchun Shen
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan, China
| | - Deyun Cheng
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan, China
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Reyes Fernandez PC, Wright CS, Warden SJ, Hum J, Farach-Carson MC, Thompson WR. Effects of Gabapentin and Pregabalin on Calcium Homeostasis: Implications for Physical Rehabilitation of Musculoskeletal Tissues. Curr Osteoporos Rep 2022; 20:365-378. [PMID: 36149592 PMCID: PMC10108402 DOI: 10.1007/s11914-022-00750-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE OF REVIEW In this review, we discuss the mechanism of action of gabapentinoids and the potential consequences of long-term treatment with these drugs on the musculoskeletal system. RECENT FINDINGS Gabapentinoids, such as gabapentin (GBP) and pregabalin (PGB) were designed as antiepileptic reagents and are now commonly used as first-line treatment for neuropathic pain and increasingly prescribed off-label for other pain disorders such as migraines and back pain. GBP and PGB exert their analgesic actions by selectively binding the α2δ1 auxiliary subunit of voltage-sensitive calcium channels, thereby inhibiting channel function. Numerous tissues express the α2δ1 subunit where GBP and PGB can alter calcium-mediated signaling events. In tissues such as bone, muscle, and cartilage, α2δ1 has important roles in skeletal formation, mechanosensation, and normal tissue function/repair that may be affected by chronic use of gabapentinoids. Long-term use of gabapentinoids is associated with detrimental musculoskeletal outcomes, including increased fracture risk. Therefore, understanding potential complications is essential for clinicians to guide appropriate treatments.
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Affiliation(s)
- Perla C Reyes Fernandez
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, 46202, USA
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, 46202, USA
| | - Christian S Wright
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, 46202, USA
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, 46202, USA
| | - Stuart J Warden
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, 46202, USA
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, 46202, USA
| | - Julia Hum
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, 46202, USA
- College of Osteopathic Medicine, Marian University, Indianapolis, IN, 4622, USA
| | - Mary C Farach-Carson
- Department of Diagnostic & Biomedical Sciences, University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, 77054, USA
| | - William R Thompson
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University, Indianapolis, IN, 46202, USA.
- Indiana Center for Musculoskeletal Health, Indiana University, Indianapolis, IN, 46202, USA.
- College of Osteopathic Medicine, Marian University, Indianapolis, IN, 4622, USA.
- Department of Anatomy and Cell Biology, Indiana University, Indianapolis, IN, 46202, USA.
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Singh K, Kumar P, Bhatia R, Mehta V, Kumar B, Akhtar MJ. Nipecotic acid as potential lead molecule for the development of GABA uptake inhibitors; structural insights and design strategies. Eur J Med Chem 2022; 234:114269. [DOI: 10.1016/j.ejmech.2022.114269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/05/2022] [Accepted: 03/05/2022] [Indexed: 11/04/2022]
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Ghosh S, Villan S, Al Yazeedi W. Gabapentin-induced myositis in a patient with spinal cord injury - a case report. Qatar Med J 2020; 2020:30. [PMID: 33282714 PMCID: PMC7684549 DOI: 10.5339/qmj.2020.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/11/2020] [Indexed: 12/04/2022] Open
Abstract
Myositis and rhabdomyolysis are the same forms of myopathy, with rhabdomyolysis being a more severe form of myopathy. Gabapentin is frequently used in patients with spinal cord injury for neuropathic pain. We report a case of probable gabapentin-induced myositis in a patient with spinal cord injury who was on an increasing dose of gabapentin. This paraplegic patient was receiving an increasing dose of gabapentin for neuropathic pain in the lower limbs. Gabapentin-induced myositis was diagnosed by a combination of new-onset generalized body pain with tenderness, an increase in creatine kinase, elevated myoglobin levels, and a score of 6 on the Naranjo adverse drug reaction probability scale. Withdrawal of the gabapentin resolved the symptoms completely. Blood parameters became normal within two weeks. We suggest that myopathy, in the form of myositis, should be recognized as a potential side effect of gabapentin in the literature.
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Affiliation(s)
- Sabyasachi Ghosh
- Physical Medicine and Rehabilitation Department, Qatar Rehabilitation Institute, Hamad Medical Corporation, Doha, Qatar
| | - Sarafdheen Villan
- Physical Medicine and Rehabilitation Department, Qatar Rehabilitation Institute, Hamad Medical Corporation, Doha, Qatar
| | - Wafa Al Yazeedi
- Physical Medicine and Rehabilitation Department, Qatar Rehabilitation Institute, Hamad Medical Corporation, Doha, Qatar
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Yao X, Tsang T, Sun Q, Quinney S, Zhang P, Ning X, Li L, Shen L. Mining and visualizing high-order directional drug interaction effects using the FAERS database. BMC Med Inform Decis Mak 2020; 20:50. [PMID: 32183790 PMCID: PMC7079342 DOI: 10.1186/s12911-020-1053-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Adverse drug events (ADEs) often occur as a result of drug-drug interactions (DDIs). The use of data mining for detecting effects of drug combinations on ADE has attracted growing attention and interest, however, most studies focused on analyzing pairwise DDIs. Recent efforts have been made to explore the directional relationships among high-dimensional drug combinations and have shown effectiveness on prediction of ADE risk. However, the existing approaches become inefficient from both computational and illustrative perspectives when considering more than three drugs. Methods We proposed an efficient approach to estimate the directional effects of high-order DDIs through frequent itemset mining, and further developed a novel visualization method to organize and present the high-order directional DDI effects involving more than three drugs in an interactive, concise and comprehensive manner. We demonstrated its performance by mining the directional DDIs associated with myopathy using a publicly available FAERS dataset. Results Directional effects of DDIs involving up to seven drugs were reported. Our analysis confirmed previously reported myopathy associated DDIs including interactions between fusidic acid with simvastatin and atorvastatin. Furthermore, we uncovered a number of novel DDIs leading to increased risk for myopathy, such as the co-administration of zoledronate with different types of drugs including antibiotics (ciprofloxacin, levofloxacin) and analgesics (acetaminophen, fentanyl, gabapentin, oxycodone). Finally, we visualized directional DDI findings via the proposed tool, which allows one to interactively select any drug combination as the baseline and zoom in/out to obtain both detailed and overall picture of interested drugs. Conclusions We developed a more efficient data mining strategy to identify high-order directional DDIs, and designed a scalable tool to visualize high-order DDI findings. The proposed method and tool have the potential to contribute to the drug interaction research and ultimately impact patient health care. Availability and implementation http://lishenlab.com/d3i/explorer.html
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Affiliation(s)
- Xiaohui Yao
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Tiffany Tsang
- Department of Computer and Information Science, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Qing Sun
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Sara Quinney
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN, 46202, USA
| | - Pengyue Zhang
- Department of Biomedical Informatics, College of Medicine, Ohio State University, Columbus, OH, 43210, USA
| | - Xia Ning
- Department of Biomedical Informatics, College of Medicine, Ohio State University, Columbus, OH, 43210, USA
| | - Lang Li
- Department of Biomedical Informatics, College of Medicine, Ohio State University, Columbus, OH, 43210, USA
| | - Li Shen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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Qiu X, Tackett E, Khitan Z. A case of gabapentin overdose induced rhabdomyolysis requiring renal replacement therapy. Clin Case Rep 2019; 7:1596-1599. [PMID: 31428399 PMCID: PMC6692987 DOI: 10.1002/ccr3.2302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/03/2019] [Accepted: 06/09/2019] [Indexed: 01/06/2023] Open
Abstract
We report a rare case with gabapentin overdose that caused severe rhabdomyolysis and acute tubular necrosis which required renal replacement therapy. A better awareness of its adverse effect and a close follow-up of laboratory tests are recommended. Prescribers should also be aware of high-risk population and monitor for signs of abuse.
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Affiliation(s)
- Xiaoliang Qiu
- Department of MedicineMarshall University Joan C. Edwards School of MedicineHuntingtonWest Virginia
| | - Eva Tackett
- Department of MedicineMarshall University Joan C. Edwards School of MedicineHuntingtonWest Virginia
| | - Zeid Khitan
- Department of MedicineMarshall University Joan C. Edwards School of MedicineHuntingtonWest Virginia
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Coupal TM, Chang DR, Pennycooke K, Ouellette HA, Munk PL. Radiologic Findings in Gabapentin-Induced Myositis. J Radiol Case Rep 2017; 11:30-37. [PMID: 28567183 DOI: 10.3941/jrcr.v11i4.3092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Throughout recent years, Gabapentin has become increasingly used for the treatment of neuropathic pain. We report on a case of a 31 year old female who presented to the emergency department with unilateral leg pain, weakness, and swelling after increasingly titrating her Gabapentin dosage over three weeks. Magnetic resonance imaging confirmed the presence of myositis confined to the left thigh and the patient's symptoms and laboratory abnormalities resolved following Gabapentin cessation. While Gabapentin-induced myositis and rhabdomyolysis is a rare entity, it should be a diagnostic consideration for radiologists, particularly in the absence of infection or trauma.
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Affiliation(s)
- Tyler Michael Coupal
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - David Ross Chang
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Kevin Pennycooke
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Hugue Alcide Ouellette
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Peter Loren Munk
- Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
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Quintero GC. Review about gabapentin misuse, interactions, contraindications and side effects. J Exp Pharmacol 2017; 9:13-21. [PMID: 28223849 PMCID: PMC5308580 DOI: 10.2147/jep.s124391] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The current work is targeted to review the risks of gabapentin misuse, its potential interactions with other drugs, side effects and use contraindications. This review consists of a total of 99 biographical references (from the year 1983 to 2016). A publication search of PubMed was performed from January 1983 to December 2016. It included animal studies, clinical studies, case studies and reviews related to gabapentin misuse, potential interactions, side effects and use contraindications. The search terms were gabapentin, anticonvulsant and antiepileptic. In general, it seems that gabapentin has risks of being misused based on the increased level of prescriptions, related fatalities, recreational misuse and higher doses of self-administration. The main reasons for gabapentin misuse are as follows: getting high, alleviating opioid withdrawal symptoms and potentiating methadone effects. Some of the main substances that interact with gabapentin are morphine, caffeine, losartan, ethacrynic acid, phenytoin, mefloquine and magnesium oxide. Some of the side effects caused by gabapentin are teratogenicity, hypoventilation, respiratory failure and myopathy. Finally, reports in general contraindicate the use of gabapentin in conditions such as myasthenia gravis and myoclonus.
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Choi MS, Jeon H, Kim HS, Jang BH, Lee YH, Park HS, Kim H, Jin DC. A case of gabapentin-induced rhabdomyolysis requiring renal replacement therapy. Hemodial Int 2016; 21:E4-E8. [PMID: 27389284 DOI: 10.1111/hdi.12458] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 06/13/2016] [Indexed: 11/28/2022]
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.
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Affiliation(s)
- Min Seok Choi
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Howook Jeon
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyo Suk Kim
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bo Hyun Jang
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoon Hee Lee
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hoon Suk Park
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - HyungWook Kim
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Chan Jin
- Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Acute Kidney Injury Associated With Alcohol and Cocaine Abuse: A Case Report. ADDICTIVE DISORDERS & THEIR TREATMENT 2016. [DOI: 10.1097/adt.0000000000000079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jiang W, Wang X, Zhou S. Rhabdomyolysis induced by antiepileptic drugs: characteristics, treatment and prognosis. Expert Opin Drug Saf 2016; 15:357-65. [DOI: 10.1517/14740338.2016.1139572] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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14
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Abstract
Muscle injury causes functional impairment. The healing process takes time and fibrotic tissue can result. Recurrence and delayed recovery remain as unsolved problems. Surgical intervention can be a feasible alternative to avoid early and late complications associated with complete muscle tear in attempt to improve functional results. This article hopes to provide an update about surgical treatments for muscle tears in different scenarios.
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Affiliation(s)
- Leonardo Addêo Ramos
- Department of Orthopaedic Surgery, Federal University of Sao Paulo, São Paulo, SP, Brazil,
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Kukkar A, Bali A, Singh N, Jaggi AS. Implications and mechanism of action of gabapentin in neuropathic pain. Arch Pharm Res 2013; 36:237-51. [PMID: 23435945 DOI: 10.1007/s12272-013-0057-y] [Citation(s) in RCA: 174] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 12/14/2012] [Indexed: 01/25/2023]
Abstract
Gabapentin is an anti-epileptic agent but now it is also recommended as first line agent in neuropathic pain, particularly in diabetic neuropathy and post herpetic neuralgia. α2δ-1, an auxillary subunit of voltage gated calcium channels, has been documented as its main target and its specific binding to this subunit is described to produce different actions responsible for pain attenuation. The binding to α2δ-1 subunits inhibits nerve injury-induced trafficking of α1 pore forming units of calcium channels (particularly N-type) from cytoplasm to plasma membrane (membrane trafficking) of pre-synaptic terminals of dorsal root ganglion (DRG) neurons and dorsal horn neurons. Furthermore, the axoplasmic transport of α2δ-1 subunits from DRG to dorsal horns neurons in the form of anterograde trafficking is also inhibited in response to gabapentin administration. Gabapentin has also been shown to induce modulate other targets including transient receptor potential channels, NMDA receptors, protein kinase C and inflammatory cytokines. It may also act on supra-spinal region to stimulate noradrenaline mediated descending inhibition, which contributes to its anti-hypersensitivity action in neuropathic pain.
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Affiliation(s)
- Ankesh Kukkar
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, 147002, Punjab, India
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Hjelmesæth J. Nyresvikt, fedme og kosthold. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2012; 132:961-2. [DOI: 10.4045/tidsskr.12.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Vilar S, Harpaz R, Chase HS, Costanzi S, Rabadan R, Friedman C. Facilitating adverse drug event detection in pharmacovigilance databases using molecular structure similarity: application to rhabdomyolysis. J Am Med Inform Assoc 2011; 18 Suppl 1:i73-80. [PMID: 21946238 DOI: 10.1136/amiajnl-2011-000417] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Adverse drug events (ADE) cause considerable harm to patients, and consequently their detection is critical for patient safety. The US Food and Drug Administration maintains an adverse event reporting system (AERS) to facilitate the detection of ADE in drugs. Various data mining approaches have been developed that use AERS to detect signals identifying associations between drugs and ADE. The signals must then be monitored further by domain experts, which is a time-consuming task. OBJECTIVE To develop a new methodology that combines existing data mining algorithms with chemical information by analysis of molecular fingerprints to enhance initial ADE signals generated from AERS, and to provide a decision support mechanism to facilitate the identification of novel adverse events. RESULTS The method achieved a significant improvement in precision in identifying known ADE, and a more than twofold signal enhancement when applied to the ADE rhabdomyolysis. The simplicity of the method assists in highlighting the etiology of the ADE by identifying structurally similar drugs. A set of drugs with strong evidence from both AERS and molecular fingerprint-based modeling is constructed for further analysis. CONCLUSION The results demonstrate that the proposed methodology could be used as a pharmacovigilance decision support tool to facilitate ADE detection.
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Affiliation(s)
- Santiago Vilar
- Department of Biomedical Informatics, Columbia University Medical Center, New York, New York 10032, USA
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Chu LC, Tsaur ML, Lin CS, Hung YC, Wang TY, Chen CC, Cheng JK. Chronic intrathecal infusion of gabapentin prevents nerve ligation-induced pain in rats. Br J Anaesth 2011; 106:699-705. [DOI: 10.1093/bja/aer063] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Zand L, McKian KP, Qian Q. Gabapentin toxicity in patients with chronic kidney disease: a preventable cause of morbidity. Am J Med 2010; 123:367-73. [PMID: 20362757 DOI: 10.1016/j.amjmed.2009.09.030] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Revised: 09/09/2009] [Accepted: 09/10/2009] [Indexed: 12/01/2022]
Abstract
BACKGROUND Gabapentin is frequently used as an analgesic in patients with chronic kidney disease. Although gabapentin is well known for its favorable pharmacokinetics, it is exclusively eliminated renally, and patients with chronic kidney disease are at risk for toxicity. Existing literature on such risk is lacking. METHODS We examined the Mayo Clinic Rochester database from 1998 to 2007 in patients with serum gabapentin measurements and known medical outcomes. A total of 729 patients were stratified according to their estimated glomerular filtration rate: group I, 126 individuals with estimated glomerular filtration greater than 90 mL/min/1.72 mm(2) [corrected] ; group II, 594 individuals with estimated glomerular filtration less than 90 mL/min/1.72 mm(2) [corrected] without dialysis; group III, 9 individuals with chronic dialysis. RESULTS Patients in groups II and III had higher serum gabapentin levels (8.39+/-0.32 microL/mL and 58.8+/-10.22 microL/mL, respectively) than in group I (5.52+/-0.32 microL/mL, P<.01). Toxicity occurred exclusively in groups II (5.56%) and III (77.8%); toxic manifestations were more severe in group III than in group II. Elderly individuals with multiple comorbidities were overrepresented in those with toxic manifestations. Gabapentin toxicity was suspected initially in only 41.5% of symptomatic cases. CONCLUSION Gabapentin toxicity in patients with chronic kidney disease is underrecognized. Patients with chronic kidney disease often receive inappropriately high gabapentin dosage for their kidney function, occasioning overt toxicity; advanced age and comorbidity predispose these patients for toxicity. Heightened awareness of such preventable risk, amid the chronic kidney disease epidemic, would be cost-effective and improve healthcare quality.
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Affiliation(s)
- Ladan Zand
- Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
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Bilgir O, Calan M, Bilgir F, Kebapçilar L, Yüksel A, Yildiz Y, Sari I. Gabapentin-induced rhabdomyolysis in a patient with diabetic neuropathy. Intern Med 2009; 48:1085-7. [PMID: 19525604 DOI: 10.2169/internalmedicine.48.1766] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Gabapentin (GBP) is a drug which is frequently used in diabetic neuropathy. Common adverse effects of GBP include drowsiness, dizziness, ataxia, somnolence, and fatigue. Rhabdomyolysis is an extremely rare side effect of GBP. In this report we describe a case of GBP-induced rhabdomyolysis in a 63-year-old diabetic woman. She presented with severe muscle pain in her extremities, fatigue, decreased urine output and urine discoloration within 3 weeks after starting treatment with GBP (900 mg/day) for diabetic neuropathy. Laboratory tests revealed extreme elevations of muscle enzymes, increased creatinine and potassium levels. She required hemodialysis as a result of anuria. Investigation confirmed the diagnosis of rhabdomyolysis, and discontinuation of GBP resulted in resolution of clinical and biochemical features of rhabdomyolysis.
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Affiliation(s)
- Oktay Bilgir
- Department of The Second Internal Medicine, Izmir Bozyaka Education and Research Hospital, Turkey.
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Current world literature. Curr Opin Neurol 2008; 21:615-24. [PMID: 18769258 DOI: 10.1097/wco.0b013e32830fb782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lapi F, Gallo E, Bernasconi S, Vietri M, Menniti-Ippolito F, Raschetti R, Gori L, Firenzuoli F, Mugelli A, Vannacci A. Myopathies associated with red yeast rice and liquorice: spontaneous reports from the Italian Surveillance System of Natural Health Products. Br J Clin Pharmacol 2008; 66:572-4. [PMID: 18637891 DOI: 10.1111/j.1365-2125.2008.03224.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2008. [DOI: 10.1002/pds.1483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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