Treatment of pregabalin toxicity by hemodialysis in a patient with kidney failure.
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.
Yoo
Lawrence
L
Division of Nephrology, New York University Medical Center, New York, NY 10010, USA.
Matalon
Daniel
D
Hoffman
Robert S
RS
Goldfarb
David S
DS
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
D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid