病例报告：巴氯芬与普瑞巴林协同导致中枢神经系统抑制：临床药师主导的病例分析与病例回顾
Case Report: Synergistic central nervous system depression of baclofen and pregabalin: clinical pharmacist-driven case analysis and case review.
作者信息
Xie Yitong, Wu Danwei, Jin Peihao, Mao Lu, Zhen Jiancun, Zhang Wei
机构信息
School of Pharmaceutical Sciences, Capital Medical University, Beijing, China.
Department of Pharmacy, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
出版信息
Front Pharmacol. 2025 Jun 5;16:1598971. doi: 10.3389/fphar.2025.1598971. eCollection 2025.
BACKGROUND
Baclofen, a γ-aminobutyric acid (GABA) derivative, and Pregabalin, a GABA analogue, are widely prescribed for muscle spasm and neuropathic pain. This first-reported case demonstrates synergistic central nervous system (CNS) depression of Baclofen (30 mg/day) and Pregabalin (300 mg/day) in a patient with mild renal impairment [estimated glomerular filtration rate, (eGFR) = 77.26 mL/min].
CASE PRESENTATION
A 68-year-old female with renal impairment developed progressive CNS depression (somnolence, coma) following combined Baclofen (30 mg/day) and Pregabalin (300 mg/day) therapy after spinal fusion surgery. CNS depression was completely resolved 48 h after drug discontinuation.
CONCLUSION
Clinicians should exercise heightened caution when combining Baclofen and Pregabalin in renal impairment. Dose adjustments based on creatinine clearance (CLcr) are strongly recommended. Particular attention should be given to initiating therapy with reduced starting doses in patients at elevated risk of CNS depression.
背景
巴氯芬是一种γ-氨基丁酸（GABA）衍生物，普瑞巴林是一种GABA类似物，二者被广泛用于治疗肌肉痉挛和神经性疼痛。本首例报告病例显示，在一名轻度肾功能损害患者[估计肾小球滤过率（eGFR）=77.26 mL/min]中，巴氯芬（30毫克/天）和普瑞巴林（300毫克/天）联用会产生协同性中枢神经系统（CNS）抑制作用。
病例介绍
一名68岁肾功能损害女性患者，在脊柱融合手术后接受巴氯芬（30毫克/天）和普瑞巴林（300毫克/天）联合治疗后，出现进行性CNS抑制（嗜睡、昏迷）。停药48小时后，CNS抑制完全缓解。
结论
临床医生在肾功能损害患者中将巴氯芬和普瑞巴林联用时应格外谨慎。强烈建议根据肌酐清除率（CLcr）调整剂量。对于CNS抑制风险较高患者，开始治疗时应特别注意降低起始剂量。
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