Possible Heart Failure Associated with Pregabalin Use-Case Report

Abstract

Pregabalin and gabapentin are widely used analgesic, anticonvulsant and anxiolytic agents as they are relatively reliable and easily tolerable. However, use of them may cause some side effects such as dizziness, somnolance, dose dependent peripheral edema and weight gain which may cause to give up the use of them. Besides, there are few reports in literature addressing old aged patients with serious chronic disease and cardiac history, develope heart failure during pregabaline application. In this case, we present a patient, without a cardiac history, treated with 300 mg/kg pregabalin due to neuropatic pain, developed peripheral and then central edema which were determined after advanced investigations. After quitting pregabalin the situation regressed. Then, peripheral edema has developed associated with recommended dose of gabapentin use instead of pregabalin. Despite the presence of any published evidence, New York Heart Association issued a warning about being careful when prescribing pregabalin to type III-IV heart failure patients. Though the effect mechanisms of pregabalin and gabapentin are not well known, calcium channel relationship may led to these side effects. In summary, we believe that pregabalin and gabapentin, which is mostly used nowadays, should be administered with care not only in patients with advanced cardiac pathology but also in all patients due to its potential side effects.