Pregabalin ilişkili döküntü: Olgu sunumu

Yıl 2013, Cilt: 4 Sayı: 1, 107 - 109, 01.03.2013

Burak Uz Ali Alkan Hakan Göker Nilgün Atakan Osman İlhami Özcebe

https://doi.org/10.5799/ahinjs.01.2013.01.0244

Öz

Kırksekiz yaşında ve 2 aydır nöropati tedavisi için 300 mg/gün oral yolla pregabalin kullanan erkek hasta, eks­tremiteler ve lomber bölgesinde eritematöz, makülopapü­ler döküntü şikayeti ile başvurdu. Naranjo olasılık skalası döküntü ve pregabalin kullanımı arasında muhtemel bir ilişkiyi gösterdi. Pregabalin tedavisi kesilerek, antihistami­nik tedavi, oral metilprednizolon ve topical steroidli krem başlandı. Tedavinin kesilmesinden 1 hafta sonra döküntü neredeyse tamamen düzeldi. Pregabalin ilişkili döküntü faz 3 klinik çalışmalarda nadiren rapor edilmiştir. Prega­balin kullanımına eşlik eden döküntü daha önce yalnızca bir vaka raporunda sunulmuştur. Pregabalin ilişkili dökün­tünün mekanizması tam olarak anlaşılamamıştır. Düşük dozlarda pregabalin tedavisine başlamak ve doz artımını yavaş yapmak yan etki insidansını azaltabilir.

Anahtar Kelimeler

pregabalin, döküntü, multipl myelom

Rash associated with Pregabalin: A case report

Öz

A 48-year-old man with erythematous, maculopapular rash localized to his extremities and lumbar region that he had been receiving oral pregabalin 300 mg per day for 2 months to treat his neuropathy was applied. The Nara­njo probability scale indicates a probable relationship be­tween the development of rash and use of pregabalin by our patient. Pregabalin was discontinued and antihista­minic treatment, oral methyprednisolone and topical ste­roid cream were given to treat the rash. The rash almost completely resolved one week after pregabalin was dis­continued. Pregabalin-induced rash was rarely reported in Phase 3 clinical trials, and there is currently only one available report on the development of a rash coinciding with the use of pregabalin. No clear mechanisms reported for rash associated with pregabalin. It is usually recom­mended to start pregabalin with low doses and slow in­creases might prevent the incidence of side effects. J Clin Exp Invest 2013; 4 (1): 107-109

Anahtar Kelimeler

pregabalin, rash, multiple myelom

Kaynakça

• Gajraj NM. Pregabalin: its pharmacology and use in pain management. Anesth Analg 2007;105:1805- 1815.
• Mula M, Pini S, Cassano GB. The role of anticonvul- sant drugs in anxiety disorders: a critical review of the evi-dence. J Clin Psychopharmacol 2007;27:263-272.
• Lozsadi D, Hemming K, Marson AG. Pregabalin add-on for drug-resistant partial epilepsy. Cochrane Database Syst Rev 2008;1:561-562.
• Arif H, Buchsbaum R, Weintraub D, et al. Comparison and predictors of rash associated with 15 antiepileptic drugs. Neurology 2007;68:1701-1709.
• Rowan AJ, Ramsay RE, Collins JF, et al. New onset geriatric epilepsy: a randomized study of gabapen- tin, lamotrigine, and carbamazepine. Neurology 2005;64:1868-1873.
• Smith TL, Baldwin A, Cunningham LL Jr, et al. Rash Associated with Pregabalin Use. Ann Pharmacother 2008;42:1899-1902.
• Pushkin R, Frassetto L, Tsourounis C, et al. Improving the reporting of adverse drug reactions in the hospital set-ting. Postgrad Med 2010;122:154-164.
• Alvestad S, Lydersen S, Brodtkorb E. Rash from anti- epileptic drugs: influence by gender, age, and learning disability. Epilepsia 2007;48:1360-1365.
• Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239-245.
• Valeyrie-Allanore L, Sassolas B, Roujeau JC. Drug- induced skin, nail and hair disorders. Drug Saf 2007;30:1011-1030.
• Richter RW, Portenoy R, Sharma U, et al. Relief of painful diabetic peripheral neuropathy with prega- balin: A randomized, placebo-controlled trial. J Pain 2005;6:253-260.
• Lesser H, Sharma U, LaMoreaux L, et al. Pregabalin relieves symptoms of painful diabetic neuropathy: A randomized controlled trial. Neurology 2004;63:2104- 2110.
• Rosenstock J, Tuchman M, LaMoreaux L, et al. Pre- gabalin for the treatment of painful diabetic peripheral neuropathy: A double blind, placebo-controlled trial. Pain 2004;110:628-638.
• Arezzo JC, Rosenstock J, Lamoreaux L, et al. Effi- cacy and safety of pregabalin 600 mg/d for treating painful diabetic peripheral neuropathy: A double-blind placebo-controlled trial. BMC Neurol 2008;8:33.
• Ben-Menachem E. Pregabalin pharmacology and its relevance to clinical practice. Epilepsia 2004;45:13- 18.