Smith Timothy L, Baldwin Aaron, Cunningham Larry L, Cook Aaron M
College of Pharmacy, University of Kentucky, Lexington, KY 40536, USA.
Ann Pharmacother. 2008 Dec;42(12):1899-902. doi: 10.1345/aph.1L305. Epub 2008 Nov 11.
To report a case of extensive rash induced by orally administered pregabalin in a patient with neuropathic pain.
A 35-year-old white female with a diffuse, erythematous, maculopapular rash localized to her back and extremities presented to the preoperative holding area for planned exploratory nerve surgery. Prior to presentation, she had been receiving oral pregabalin 50 mg 3 times a day for approximately 2 weeks to treat her neuropathy. Prior to pregabalin therapy, the patient indicated that she had taken gabapentin for approximately 3 weeks for the pain, but had discontinued it due to adverse effects and perceived lack of efficacy. Pregabalin was discontinued and diphenhydramine and methylprednisolone 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 trials, and a clinical description of such events has not been published. Pregabalin exhibits pharmacokinetics different from those of most other antiepileptic agents. Presently, there are no clear mechanisms known for rash associated with pregabalin. The Naranjo probability scale indicates a probable relationship between the development of rash and use of pregabalin by our patient.
There are currently no other available reports of the development of a rash coinciding with the use of pregabalin. As both Food and Drug Administration-approved and off-label use of this drug increases, further consideration of risk factors associated with the development of rash is needed.
报告1例口服普瑞巴林后在1例神经性疼痛患者中诱发广泛皮疹的病例。
一名35岁白人女性，其背部和四肢出现弥漫性、红斑性、斑丘疹皮疹，被送至术前等候区准备进行计划中的探索性神经手术。就诊前，她每天口服3次50毫克普瑞巴林，持续约2周以治疗其神经病变。在使用普瑞巴林治疗之前，患者表示她曾服用加巴喷丁约3周来止痛，但因不良反应和感觉缺乏疗效而停药。停用普瑞巴林，并给予苯海拉明和甲泼尼龙治疗皮疹。停用普瑞巴林1周后皮疹几乎完全消退。
普瑞巴林诱发的皮疹在3期试验中鲜有报道，此类事件的临床描述尚未发表。普瑞巴林的药代动力学与大多数其他抗癫痫药物不同。目前，尚不清楚与普瑞巴林相关皮疹的明确机制。纳伦霍概率量表表明我们的患者出现皮疹与使用普瑞巴林之间可能存在关联。
目前尚无其他关于使用普瑞巴林同时出现皮疹的报道。随着该药物经美国食品药品监督管理局批准的用途和超说明书用途的增加，需要进一步考虑与皮疹发生相关的危险因素。
