Treatment of pregabalin toxicity by hemodialysis in a patient with kidney failure

Am J Kidney Dis. 2009 Dec;54(6):1127-30. doi: 10.1053/j.ajkd.2009.04.014. Epub 2009 Jun 3.

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Analgesics / blood
  • Analgesics / poisoning*
  • Analgesics / therapeutic use
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / therapy*
  • Neuralgia / drug therapy
  • Pregabalin
  • Renal Dialysis*
  • Time Factors
  • Treatment Outcome
  • gamma-Aminobutyric Acid / analogs & derivatives*
  • gamma-Aminobutyric Acid / blood
  • gamma-Aminobutyric Acid / poisoning
  • gamma-Aminobutyric Acid / therapeutic use

Substances

  • Analgesics
  • Pregabalin
  • gamma-Aminobutyric Acid