title: Treatment of pregabalin toxicity by hemodialysis in a patient with kidney failure.
abstract: Pregabalin is prescribed for neuropathic pain. We report the first case of pregabalin toxicity in a hemodialysis patient and her successful treatment with hemodialysis. The patient was a 30-year-old woman on long-term hemodialysis therapy who experienced significant myoclonus of the arms and legs when her dose of pregabalin was mistakenly increased. The drug has 3 properties that contribute to making it amenable to removal by hemodialysis: relatively low molecular weight (159.23 Da), relatively low volume of distribution (0.5 L/kg), and not bound to plasma proteins. We achieved hemodialysis clearance of 88.8 mL/min, which was associated with resolution of symptoms immediately after hemodialysis.
authors.affiliation: Division of Nephrology, New York University Medical Center, New York, NY 10010, USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Yoo
authors.forename: Daniel
authors.initials: D
authors.lastname: Matalon
authors.forename: Robert S
authors.initials: RS
authors.lastname: Hoffman
authors.forename: David S
authors.initials: DS
authors.lastname: Goldfarb
mesh_terms: D000328:Adult; D000700:Analgesics / Q000097:blood / Q000506:poisoning* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D009437:Neuralgia / Q000188:drug therapy; D000069583:Pregabalin; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000097:blood / Q000506:poisoning / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid