Reactions 1392 - 10 Mar 2012

SPregabalin

Possible heart failure: case reportA 54-year-old woman developed possible heart failure

while receiving pregabalin [route not stated] for intercostalneuralgia.

The woman, who had a history of bilateral thoracicsympathectomy, started treatment with pregabalin150 mg/day for the first week, followed by 300 mg/day inthe second week. Tramadol was also administered. Duringfollow-up on day 17 of treatment, she reported a 3-dayhistory of swelling in her hands and ankles. Pretibialoedema was evident on examination and she was admittedfor side-effect follow-up and pain palliation. Her peripheraloedema was initially attributed to pregabalin and the drugwas withdrawn. Tramadol was administered via patient-controlled analgesia until day 3, and treatment wasmaintained with oral tramadol. Salbutamol [albuterol] wasadministered for occasional slight dyspnoea. At the end of1 week, she was discharged with pain palliation, reducedperipheral oedema, and treatment with tramadol. Duringfollow-up, a thorax CT scan revealed cardiomegalia, thepresence of pericardial fluid, and pleural fluid at the base ofboth hemithorax, more significantly on the right side.

Diuretic therapy was initiated and, on day 3 of treatment,echocardiography showed an ejection fraction of 76%. Afollow-up thorax CT scan, performed 15 days afterdiscontinuing pregabalin, revealed disappearance of thecardiomegalia and pericardial fluid, with only minimalpleural effusion. The woman’s peripheral oedema anddyspnoea had also subsided. Following reports of reducedbut persistent pain, gabapentin 300 mg/day was initiated,followed by a dosage increase to 900 mg/day. Shedeveloped oedema approximately 20 days later andgabapentin was withdrawn. Analgesia was maintained withtramadol. Her oedema due to gabapentin regressed onday 3.

Author comment: "Accordingly, the drug scored 7 on theNaranjo algorithm and accepted as having potential sideeffects."Erdogan G, et al. Possible heart failure associated with pregabalin use: case report.Agri 23: 80-3, No. 2, Apr 2011 - Turkey 803067806

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Reactions 10 Mar 2012 No. 13920114-9954/10/1392-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved