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Gabapentin is not known to harm the liver, but it can cause a rare allergic reaction called DRESS syndrome that can affect the liver and kidneys. Learn about gabapentin dosing, side effects, and interactions with other medications. Gabapentin and other adjuvant analgesics can be considered; consider side effect profile and tailor analgesic plan to specific liver disease complications (e.g. hepatic encephalopathy, fluctuating renal function, varices) Gabapentin enacarbil and gabapentin are associated with a low rate of transient serum enzyme elevations during treatment and with rare instances of clinically apparent liver injury. Gabapentin enacarbil is a long acting form of gabapentin that is used for restless leg syndrome and for painful postherpetic neuropathy. Gabapentin is not metabolized by the liver. Instead, it is excreted unchanged in your kidneys after circulating in your blood. Gabapentin affects nerves and chemicals in your body that are involved in some types of pain and in seizures. Herein, we report a gabapentin-induced hepatocellular injury in a patient without another identifiable cause for acute liver injury. Discontinuing gabapentin resulted in rapid reversal improvement in hepatocellular injury. Keywords: gabapentin, hepatotoxicity, drug-induced liver injury. A drug-induced liver injury is one of the most common causes of acute liver failure. While acetaminophen is the most common etiology, other offending medications include amoxicillin-clavulanic acid, amiodarone, isoniazid, and fluoroquinolones to name a few. Gabapentin, a gamma-aminobutyric acid (GAB Therefore, risks in patients with advanced liver disease are not greatly increased. However, there are case reports of pregabalin‐induced hepatoxicity. 4 Gabapentin and pregabalin are renally excreted, so dosages need to be adjusted for renal failure. Therapy with gabapentin is not associated with serum aminotransferase elevations, but several cases of clinically apparent liver injury from gabapentin have been reported. Gabapentin, which has been FDA-approved for the treatment of postherpetic neuralgia in adults, is commonly used for this disorder. Gabapentin, a water-soluble amino acid, is eliminated Clinical case: 56-year-old male patient with a history of chronic kidney disease on hemodialysis and narrowing of the spinal canal under treatment with gabapentin, who presented acute liver injury probably secondary to a dose of gabapentin; however, it remitted with the suspension of said drug. Gabapentin is a prescription drug that can help ease the pain of liver cirrhosis, a serious condition that involves liver scarring. Learn about the benefits, risks and alternatives of gabapentin for liver cirrhosis, as well as the causes, stages and complications of the disease. Gabapentin is an anticonvulsant medication commonly used to treat epilepsy and neuropathic pain. Rare cases of liver and kidney damage have been reported with Gabapentin use. Individuals with pre-existing liver or kidney conditions may be at a higher risk. Regular monitoring of liver and kidney function is essential while taking Gabapentin. Other AEDs with rising and currently highest prescription rates were associated with few or no cases of liver injury including gabapentin (45.3 million), clonazepam (18.8 million), pregabalin (10.6 million), topiramate (9.3 million), and levetiracetam (7.7 million) and many of cases were judged as only “probable”. Drug manufacturer Pfizer classifies abnormal liver function tests as an infrequent side effect for gabapentin 5. There is insufficient data to estimate incidence for these or establish whether gabapentin is the sole cause of elevated liver function tests, notes Pfizer. Gabapentin is not metabolized by the liver. Rare cases of liver and kidney damage have been reported with Gabapentin use. Individuals with pre-existing liver or kidney conditions may be at a higher risk. Regular monitoring of liver and kidney function is essential while taking Gabapentin. This article focuses on the acute and chronic treatment of seizures in patients with advanced liver disease and reviews the hepatotoxic potential of specific antiepileptic drugs. Newer antiepileptic drugs without, or with minimal, hepatic metabolism, such as levetiracetam, lacosamide, topiramate, gabapentin, and pregabalin should be used as Several studies demonstrated that chronic treatment with gabapentin may alter liver and renal Dose adaptation for liver disease is important in patients treated with antineoplastic drugs Patients with liver disease may require long-term AED treatment. The selection of AEDs in these individuals deserves careful consideration. Drug metabolism depends on the integrity of the hepatocyte, the blood flow, and the patency of the hepatobiliary system. 5 Because of the large hepatic reserve, the liver dysfunction must be severe to cause substantial alterations in drug metabolism. 27 Prior lab review showed liver enzymes within normal limits until one month prior to admission, when his ALP was 851. He started taking gabapentin, without introduction of any other medications, one month prior to the initial rise in ALP . Evaluation for viral, inherited, and metabolic causes of liver disease were negative. Herein, we report a gabapentin-induced hepatocellular injury in a patient without another identifiable cause for acute liver injury. Discontinuing gabapentin resulted in rapid reversal improvement in hepatocellular injury. Keywords: drug-induced liver injury; gabapentin; hepatotoxicity.
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