Treatment of Pregabalin Toxicity by Hemodialysis in a Patient With Kidney Failure

Pregabalin is prescribed for neuropathic pain. We report the first case of pregabalin toxicity in a hemodialysis patient and her successful treatment with hemodialysis. The patient was a 30-year-old woman on long-term hemodialysis therapy who experienced significant myoclonus of the arms and legs when her dose of pregabalin was mistakenly increased. The drug has 3 properties that contribute to making it amenable to removal by hemodialysis: relatively low molecular weight (159.23 Da), relatively low volume of distribution (0.5 L/kg), and not bound to plasma proteins. We achieved hemodialysis clearance of 88.8 mL/min, which was associated with resolution of symptoms immediately after hemodialysis.

Index Words: 3-Isobutyl γ-aminobutyric acid (GABA), gabapentin, γ-aminobutyric acid, intoxication, Lyrica, poisoning, renal dialysis