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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. 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. 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. 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. 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. Liver enzymes are proteins your liver uses for normal liver functions. When your liver is damaged, these enzymes leak out into your blood and can be measured with blood testing called liver function testing. There are several liver enzymes, but the ones that show liver damage from medications are aspartate transaminase (AST) and alanine 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 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 caused elevated liver function enzymes AST, ALT, and ALP beside bilirubin. Gabapentin effects on lipid profile, Blood electrolytes, and functions of kidney and liver of laboratory The activity of liver enzymes, with 20 mg/kg of GPN were not significantly different from the control group but, the serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, direct bilirubin and total bilirubin were enhanced significantly with 100 mg/kg of GPN. 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. Magnetic resonance cholangiopancreatography showed no biliary abnormalities. After gabapentin was discontinued, liver enzymes began to downtrend with discharge values of AST 16, ALT 35, ALP 413, Tbili 9.3 and INR 1.1 (Figure). Discussion: Gabapentin induced liver injury is rare with few reported cases, many of which did not exclude other Gabapentin and Cirrhosis of the Liver - Fatty Liver Disease Gabapentin (Neurontin) usually isn’t bad for your liver or kidneys. In most cases, it has little effect on these organs. In rare instances, gabapentin can cause DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome. 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 unchanged 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”.
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