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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. As a therapeutic class, AED’s are consistently ranked among the top causes of clinically apparent liver injury and are a common cause for drug-induced acute liver failure (2–5). Currently, 30 AEDs are approved for use in the United States. 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. 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. Purpose: Trazodone and gabapentin are commonly used treatments. We report a rare case of trazodone and gabapentin-induced liver injury. Case: A 40-year-old woman with a history of depression presented jaundice. She had no other complaints. The patient denied risk factors for acute and chronic liver disease. Gabapentin, a common over-the-counter pain reliever and fever reducer, has been linked to rare individual case reports of liver injury. The causal relationship between gabapentin and liver damage is unclear, with the latency to onset being 1 to 8 weeks. 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. 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. Therapy with gabapentin is not associated with serum aminotransferase elevations, but several cases of clinically apparent liver injury from gabapentin have been reported. Gabapentin is a unique anticonvulsant that is used as adjunctive therapy in management of epilepsy and for neuropathic pain syndromes. Gabapentin is an anti-convulsant that is also used off-label to treat neuropathic pain. It is not metabolized by the liver, and there have been few reports of hepatotoxity associated with it. We present a rare case of gabapentin-induced hepatotoxicity occurring in a young male. Gabapentin has been implicated in isolated cases of acute liver injury, but in most instances the association was weakened by the coadministration with other potentially hepatotoxic agents. Too few cases have been reported in sufficient detail to characterize the clinical features of the associated injury. Liver injury may occur from paracetamol overdose 16 and in rare cases from repeated therapeutic doses in patients with glutathione deficiency risk factors such as malnutrition, chronic illness, or chronic alcohol ingestion. 17 Although the half-life of paracetamol may be prolonged in patients with chronic liver disease, CYP450 content is not Medications like Tylenol and Aleve are hepatotoxic, meaning they could raise liver enzymes and damage your liver over time. See the list of medications to avoid. Hepatotoxicity is implies chemical-driven liver damage and it's a cause of acute and chronic liver disease with cancer based tumors [25] [26] [27]. Therefore, selective and sensitive monitoring In most cases, gabapentin doesn’t hurt the liver or kidneys, though proper dosing is important to prevent side effects. Learn how gabapentin affects the liver and kidneys here. We would like to show you a description here but the site won’t allow us. 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) A recent case report from Sweden determined that pregabalin was a probable cause of acute liver failure in a 61-year-old healthy man with no previous liver disease. 47 Although this may have been an idiosyncratic event because no further case reports have been published in the literature, clinicians must be mindful of the increased risk of drug Gabapentin and Cirrhosis of the Liver - Fatty Liver Disease 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
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