Gabapentin-induced rhabdomyolysis in a patient with diabetic neuropathy

Intern Med. 2009;48(12):1085-7. doi: 10.2169/internalmedicine.48.1766. Epub 2009 Jun 15.

Abstract

Gabapentin (GBP) is a drug which is frequently used in diabetic neuropathy. Common adverse effects of GBP include drowsiness, dizziness, ataxia, somnolence, and fatigue. Rhabdomyolysis is an extremely rare side effect of GBP. In this report we describe a case of GBP-induced rhabdomyolysis in a 63-year-old diabetic woman. She presented with severe muscle pain in her extremities, fatigue, decreased urine output and urine discoloration within 3 weeks after starting treatment with GBP (900 mg/day) for diabetic neuropathy. Laboratory tests revealed extreme elevations of muscle enzymes, increased creatinine and potassium levels. She required hemodialysis as a result of anuria. Investigation confirmed the diagnosis of rhabdomyolysis, and discontinuation of GBP resulted in resolution of clinical and biochemical features of rhabdomyolysis.

Publication types

  • Case Reports

MeSH terms

  • Amines / adverse effects*
  • Amines / therapeutic use*
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use*
  • Creatinine / blood
  • Cyclohexanecarboxylic Acids / adverse effects*
  • Cyclohexanecarboxylic Acids / therapeutic use*
  • Diabetic Nephropathies / drug therapy*
  • Dose-Response Relationship, Drug
  • Female
  • Gabapentin
  • Humans
  • Middle Aged
  • Muscle, Skeletal / enzymology
  • Potassium / blood
  • Rhabdomyolysis / blood
  • Rhabdomyolysis / chemically induced*
  • Rhabdomyolysis / diagnosis*
  • gamma-Aminobutyric Acid / adverse effects*
  • gamma-Aminobutyric Acid / therapeutic use*

Substances

  • Amines
  • Anticonvulsants
  • Cyclohexanecarboxylic Acids
  • gamma-Aminobutyric Acid
  • Gabapentin
  • Creatinine
  • Potassium