[Rhabdomyolysis from gabapentin: a case report]

Area of Science:

• Pharmacology
• Nephrology
• Neurology

Background:

• Gabapentin (GBP) is an anticonvulsant medication with various therapeutic uses.
• It is primarily excreted unchanged by the kidneys, necessitating dose adjustments in patients with renal impairment.
• Common side effects include dizziness and fatigue, while rhabdomyolysis is an exceptionally rare adverse event.

Observation:

• A case study involving a 65-year-old diabetic male with chronic renal failure (CRF) undergoing peritoneal dialysis (PD) is presented.
• The patient developed symptoms of weakness, myalgias, and hypotension after initiating GBP therapy for neuropathic pain.
• Laboratory results indicated elevated muscle necrosis markers, confirming rhabdomyolysis.

Findings:

• The patient's rhabdomyolysis resolved upon immediate discontinuation of Gabapentin and continuation of CAPD dialysis.
• Only three cases of GBP-induced rhabdomyolysis have been reported in the last decade.
• Peritoneal dialysis (PD) may be less effective than continuous extracorporeal treatments for managing drug-induced toxicity in renal failure.

Implications:

• Gabapentin (GBP) should be considered a potential cause of rhabdomyolysis, especially in patients with chronic renal failure (CRF).
• Clinicians should maintain a high index of suspicion for GBP toxicity in CRF patients, as it is often overlooked.
• Close monitoring of laboratory tests is recommended to facilitate early detection of adverse reactions to Gabapentin in this vulnerable population.