Rash associated with pregabalin use.
OBJECTIVE
To report a case of extensive rash induced by orally administered pregabalin in a patient with neuropathic pain.


METHODS
A 35-year-old white female with a diffuse, erythematous, maculopapular rash localized to her back and extremities presented to the preoperative holding area for planned exploratory nerve surgery. Prior to presentation, she had been receiving oral pregabalin 50 mg 3 times a day for approximately 2 weeks to treat her neuropathy. Prior to pregabalin therapy, the patient indicated that she had taken gabapentin for approximately 3 weeks for the pain, but had discontinued it due to adverse effects and perceived lack of efficacy. Pregabalin was discontinued and diphenhydramine and methylprednisolone were given to treat the rash. The rash almost completely resolved one week after pregabalin was discontinued.


CONCLUSIONS
Pregabalin-induced rash was rarely reported in Phase 3 trials, and a clinical description of such events has not been published. Pregabalin exhibits pharmacokinetics different from those of most other antiepileptic agents. Presently, there are no clear mechanisms known for rash associated with pregabalin. The Naranjo probability scale indicates a probable relationship between the development of rash and use of pregabalin by our patient.


CONCLUSIONS
There are currently no other available reports of the development of a rash coinciding with the use of pregabalin. As both Food and Drug Administration-approved and off-label use of this drug increases, further consideration of risk factors associated with the development of rash is needed.
Smith
Timothy L
TL
College of Pharmacy, University of Kentucky, Lexington, KY 40536, USA.
Baldwin
Aaron
A
Cunningham
Larry L
LL
Cook
Aaron M
AM
D000284:Administration, Oral; D000328:Adult; D000700:Analgesics / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D004155:Diphenhydramine / Q000627:therapeutic use; D003875:Drug Eruptions / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D009437:Neuralgia / Q000188:drug therapy; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use
D000700:Analgesics; D018926:Anti-Allergic Agents; D005938:Glucocorticoids; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D004155:Diphenhydramine; D008775:Methylprednisolone