Liver damage with pregabalin (LYRICA): A 55-year old woman was taking pregabalin (LYRICA) and occasionally ibuprofen (IBUPROFEN ABZ etc.) because of pain after herpes zoster infection. While on these medicines she experienced a decline in performance, slight weight loss, brown-coloured urine, and jaundice. In hospital, tests showed values for total bilirubin were more than double the upper limit of normal, for GOT 9 times, and for GPT more than 20 times. The abdominal ultrasound was unremarkable and there was no evidence of an infectious or autoimmune aetiology for the hepatitis. After pregabalin was discontinued, the transaminases fell. It is assumed the source is most likely drug-induced and toxic in nature (NETZWERK Report 16.580). Beside pregabalin, ibuprofen may also be the trigger (1). The European Medicines Agency overviews at least 31 reports of suspected hepatitis and at least 17 of liver failure in relation to pregabalin (2). There are also several reports in the literature about liver damage while taking this drug (3-5). To date, they have not been listed as an adverse effect in the pregabalin summary of product characteristics (SPC; 6).

1

AbZ-Pharma: SPC IBUPROFEN ABZ 200 Tbl., as at Dec. 2013

2

European database of suspected adverse drug reaction reports, web report on pregabalin, as at Febr. 2014; to be found at http://www.adrreports.eu

3

EINARSDOTTIR, S., BJÖRNSSON, E.: Eur. J. Gastroenterol. Hepatol. 2008; 20: 1049

4

DOGAN, S. et al.: Eur. J. Gastroenterol. Hepatol. 2011; 23: 628

5

SENDRA, J.M. et al.: Ann. Pharmacother. 2011; 45: e32 (3 pages)

6

Pfizer: SPC LYRICA, as at Jan. 2014