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Background Gabapentin and pregabalin are commonly prescribed medications to treat pain in patients with diabetic neuropathy. Gabapentin and pregabalin can cause fluid retention, which is hypothesized to be associated with cardiovascular diseases. However, whether long-term use of gabapentin and pregabalin is associated with adverse cardiovascular diseases remains unknown. This study aims to In this report, we present a patient with no cardiac history treated with 300 mg/kg pregabalin due to neuropathic pain, who developed peripheral and then central edema, which were determined after advanced investigations. After stopping pregabalin, the situation regressed. Although less common than central nervous system toxicities, cardiovascular toxicities of gabapentin and pregabalin may lead to serious consequences, including worsening heart failure and arrhythmias. Furthermore, individuals for whom pregabalin is often prescribed, such as diabetic patients, tend to have renal or cardiac disease, which are known risk factors for heart failure . In clinical practice, the high background incidence of edema and heart failure may reduce the likelihood that health care providers attribute these problems to a Oral and intravenous gabapentin can markedly attenuate blood pressure (BP) in hypertensive rats. The nucleus tractus solitarii (NTS) is the primary integrative center for cardiovascular control and other autonomic functions in the central nervous system. There were significant associations between short-term (3 month) gabapentin use and heart failure, myocardial infarction, peripheral vascular disease, deep venous thrombosis, and pulmonary Short-term (3 month) pregabalin use was associated with deep venous thrombosis and peripheral vascular disease. Associations between gabapentin, pregabalin and heart failure have been reported in case reports [38, 39], but not in observational studies [40, 41]. Patients prescribed gabapentin repeatedly were at a higher 5-year risk of peripheral vascular disease, heart failure, and myocardial infarction. Although other adverse cardiovascular events showed no significant associations in the 5-year follow-up, there was an increased trend in patients prescribed gabapentinoids. The association of widely used neurological agents gabapentin and pregabalin and heart failure (HF) is not widely known, although fluid retention after their use in the form of peripheral edema has been recognized. Introduction: Gabapentinoids are ligands of the α2-δ subunit of voltage-gated calcium channels (Cav) that have been associated with a risk of peripheral edema and acute heart failure in connection with a potentially dual mechanism, vascular and cardiac. Gabapentin is a commonly used medication used as an anti-convulsant or analgesic. The well-known side-effects of gabapentin are dizziness, drowsiness and fatigue. In rare cases, it can lead to development of new onset congestive heart failure (CHF) or decompensation of pre-existing CHF. Patients prescribed gabapentin repeatedly were at a higher 5-year risk of peripheral vascular disease, heart failure, and myocardial infarction. Although other adverse cardiovascular events showed no significant associations in the 5-year follow-up, there was an increased trend in patients prescribed gabapentinoids. duced heart failure. J Amer Coll Cardiol Mar,79 (9_Supplement). 2231; 2022. 5. Tellor KB, Ngo-Lam R, Badran D, Armbruster AL, Schwarze MW. A rare case of a gabapentin-induced cardiomyopathy. J Clin Pharm Ther. 2019; 44: 644-646. 6. Wynn E, Biskupiak J, K Kibum, Munger MA. Pregabalin use in-creases the risk of acute heart failure in patients In the primary analysis, we found no difference in the risk of heart failure with pregabalin compared to gabapentin (1.2% versus 1.3%, hazard ratio of 0.77; 95% CI 0.58-1.03). Secondary analyses stratified for baseline history of heart failure yielded similar findings. Although the most frequent side effects of gabapentin are associated with the central nervous system, gabapentin can also affect the cardiovascular system. Case reports and observational studies have showed that gabapentin can be associated with increased risk of atrial fibrillation. In patients with diabetic neuropathy who were prescribed gabapentin and pregabalin, there is an increased risk for heart failure, myocardial infarction, peripheral vascular disease, stroke, deep venous thrombosis, and pulmonary embolism with long-term use. Gabapentin (GBP), a GABA analogue, is primarily used as an anticonvulsant for the treatment of partial seizures and neuropathic pain. Whereas a majority of the side effects are associated with the nervous system, emerging evidence suggests there is a high risk of heart diseases in patients taking GBP. in 2014 and gabapentin is often prescribed “o label” to treat diabetic neuropathy [3]. Both gabapentin and pregabalin can cause uid reten-tion by altering arterial myogenic tone [4]. Although uid retention is not a recognized risk factor for cardiovas-cular disease, every medical condition that causes uid Gabapentinoids can cause concentration-dependent peripheral edema of early onset. Reduced myogenic tone is the main mechanism of these non-cardiogenic edemas. In case of peripheral edema or heart failure, a drug etiology should be considered. A recently published report describes the case of a patient who developed non-ischemic cardiomyopathy following initiation of gabapentin therapy for pain management.. The patient, a 44-year-old African American female, with no prior cardiac history, presented to the emergency department (ED) complaining of shortness of breath and cough.
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