Gabapentin Toxicity Requiring Intubation in a Patient Receiving Long-Term Hemodialysis

Letters2 July 2002Gabapentin Toxicity Requiring Intubation in a Patient Receiving Long-Term HemodialysisHeather Jones, MD, Elvira Aguila, MD, and Harrison W. Farber, MDHeather Jones, MDBoston Medical Center; Boston, MA 02118 (Jones, Aguila, Farber)Search for more papers by this author, Elvira Aguila, MDBoston Medical Center; Boston, MA 02118 (Jones, Aguila, Farber)Search for more papers by this author, and Harrison W. Farber, MDBoston Medical Center; Boston, MA 02118 (Jones, Aguila, Farber)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-1-200207020-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Gabapentin, or 1-(aminomethyl) cyclohexaneacetic acid, is an antiepileptic medication used increasingly to treat neuropathies. It is highly lipid and water soluble and is excreted by the kidneys. Its half-life is 5 to 7 hours in healthy persons; in patients with renal failure, its half-life is 132 hours during nonhemodialysis periods and 3.8 hours during hemodialysis (1, 2). Thus far, massive gabapentin overdose has been associated with few adverse effects (3-5).A 46-year-old woman with end-stage renal disease was admitted somnolent and hypoxic after taking multiple doses of gabapentin over 2 days without intervening hemodialysis. The patient was ...References1. Wong MO, Eldon MA, Keane WF, Turck D, Bockbrader HN, Underwood BA, et al . Disposition of gabapentin in anuric subjects on hemodialysis. J Clin Pharmacol. 1995;35:622-6. [PMID: 7665723] CrossrefMedlineGoogle Scholar2. Blum RA, Comstock TJ, Sica DA, Schultz RW, Keller E, Reetze P, et al . Pharmacokinetics of gabapentin in subjects with various degrees of renal function. Clin Pharmacol Ther. 1994;56:154-9. [PMID: 8062491] CrossrefMedlineGoogle Scholar3. Verma A, Clair EW, Radtke RA. A case of sustained massive gabapentin overdose without serious side effects. Ther Drug Monit. 1999;21:615-7. [PMID: 10604821] CrossrefMedlineGoogle Scholar4. Fischer JH, Barr AN, Rogers SL, Fischer PA, Trudeau VL. Lack of serious toxicity following gabapentin overdose. Neurology. 1994;44:982-3. [PMID: 8190316] CrossrefMedlineGoogle Scholar5. Fernandez MC, Walter FG, Kloster JC, Do SM, Brady LA, Villarin A, et al . Hemodialysis and hemoperfusion for treatment of valproic acid and gabapentin poisoning. Vet Human Toxicol. 1996;38:438-43. [PMID: 8948077] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Heather Jones, MD; Elvira Aguila, MD; Harrison W. Farber, MDAffiliations: Boston Medical Center; Boston, MA 02118 (Jones, Aguila, Farber) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byExtracorporeal Treatment for Gabapentin and Pregabalin Poisoning: Systematic Review and Recommendations From the EXTRIP WorkgroupLes gabapentinoïdes : une revue de la littératureA fatality involving massive overdose of gabapentinA case of gabapentin overdose induced rhabdomyolysis requiring renal replacement therapyMyoclonus and Altered Mental Status Induced by Single Dose of Gabapentin in a Patient With End-Stage Renal Disease: A Case Report and Literature ReviewGabapentin and Pregabalin Use and Association with Adverse Outcomes among Hemodialysis PatientsSecond Generation Anticonvulsants: Gabapentin, Lamotrigine, Levetiracetam, and TopiramateSecond Generation Anticonvulsants: Gabapentin, Lamotrigine, Levetiracetam, and TopiramateGabapentin misuse, abuse and diversion: a systematic reviewSecond Generation Anticonvulsants: Gabapentin, Lamotrigene, Leveticetam, and TopiramateGabapentin for Uremic Pruritus in Hemodialysis Patients: A Qualitative Systematic ReviewGabapentinClinical Outcomes in Newer Anticonvulsant Overdose: A Poison Center Observational StudySuicide by Gabapentin OverdoseThe Management of Diabetic Neuropathy in CKDSeizures in Fulminant Hepatic Failure, Multiorgan Failure, and Endocrine CrisisGabapentin Toxicity in Renal Failure: The Importance of Dose AdjustmentNeuropathic pain in children after exposure to mercuryAntiepileptic Drugs in the Treatment ofNeuropathic PainNeuropsychiatric Complications and Psychopharmacology of End-Stage Renal DiseaseShould Gabapentin Be Dose Adjusted: What are the Clinical Consequences?Gabapentin-Induced Neurologic ToxicitiesGabapentin for uraemic pruritusTreatment of Cancer PainAnalgesia in patients with ESRD: a review of available evidenceThe role of gabapentin in treating diseases with cutaneous manifestations and painGabapentinSeizures in Renal and Hepatic Failure and Endocrine Disease 2 July 2002Volume 137, Issue 1Page: 74KeywordsExtubationHalf lifeIntubationKidneysLipidsNeuropathyOxygenRenal failureShockToxicity ePublished: 2 July 2002 Issue Published: 2 July 2002 Copyright & PermissionsCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...