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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. Hepatic impairment: The American Association for the Study of Liver Disease (AASLD) recognizes the potential role of gabapentin as a primary non-opioid therapeutic choice, particularly for managing neuropathic pain in patients with cirrhosis. Gabapentin and Cirrhosis of the Liver - Fatty Liver Disease The risk of liver damage is higher for people with other liver infections, like hepatitis B, who have alcohol use disorder or who take other medicines that can damage the liver. But one study found that long-term ART doesn’t increase the risk of liver damage. Changes in liver function may be attributed to free radical damage induced by gabapentin, as documented in this study, where the drug enhanced antioxidant defense systems and elevated liver NO Question. I have a patient with trigeminal neuralgia who was taking 1600 mg of gabapentin and had serious elevations of liver function tests (aspartate transaminase 258 U/L, alanine transaminase Gabapentin-Induced Liver Toxicity. Chahal, Japjot MD 1; Arif, Muhammad Osman MD 2; Achufusi, Ted George MD 1. Author Information . 1 Internal Medicine, SUNY Upstate Gabapentin is an uncommon cause of DILI reported to cause a hepatocellular, cholestatic, or mixed picture of liver injury. Given the limitations of prior cases, we feel our report most closely ties gabapentin use to the resultant transaminase elevation. 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 (gab" a pen' tin) enacarbil (en" a kar' bil) is a prodrug of and long acting form of gabapentin. 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. Histologically, acute hepatitis was seen in five cases, and chronic hepatitis was seen in one case. Gabapentin was reported to cause cholestasis in two case reports. Despite the small number of reported cases of hepatotoxicity, trazodone and gabapentin are known causes of liver injury, and clinicians should be aware of this possibility. This class, which includes gabapentin and pregabalin, is not metabolized by the liver. 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. Gabapentin is a prescription drug for seizures and nerve pain. It usually doesn't harm the liver or kidneys, but it can cause a rare allergic reaction called DRESS syndrome. Learn more about gabapentin dosing, side effects, and interactions. 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”. Detailed Gabapentin dosage information for adults and children. Includes dosages for Restless Legs Syndrome, Epilepsy and Postherpetic Neuralgia; plus renal, liver and dialysis adjustments. 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. Gabapentin-Induced Liver Toxicity Am J Ther. 2022 Nov-Dec;29(6):e751-e752. doi: 10.1097/MJT.0000000000001208. Epub 2020 Jun 5. Authors Japjot Chahal 1 Learn about the potential effects of Gabapentin on your liver and kidneys. Find out if it is safe to use and how to protect your organs while taking this medication. We can help! Gabapentin induced liver injury is rare with few reported cases, many of which did not exclude other etiologies. In this case, the key elements of diagnosing DILI were met including gabapentin initiation closely preceding liver injury, other etiologies excluded, and discontinuation of gabapentin leading to improvement. Gabapentin is a unique anticonvulsant that is used as adjunctive therapy in management of epilepsy and for neuropathic pain syndromes. Therapy with gabapentin is not associated with serum aminotransferase elevations, but several cases of clinically apparent liver injury from gabapentin have been reported.
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