Cardiovascular Safety of Gabapentinoids

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• Murphy N, Mockler M, Ryder M, Ledwidge M, McDonald K. Decompensation of chronic heart failure associated with pregabalin in patients with neuropathic pain. J Card Fail [Internet]. 2007 [cited 2018 Dec 15];13:227–229. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17448421 . This was one of the first case reports that described worsening heart failure associated with pregabalin use.

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Fong T, Lee AJ. Pregabalin-associated heart failure decompensation in a patient with a history of stage I heart failure. Ann Pharmacother [Internet]. 2014 [cited 2019 Jan 28];48:1077–1081. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24769529

Guzelkucuk U, Duman I, Yılmaz B, Tan AK. Reversible post-pregabalin peripheral edema in a spinal cord injury patient. Spinal Cord [Internet]. 2012 [cited 2018 Dec 15];50:472–473. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21747401

Gallagher R, Apostle N. Peripheral edema with pregabalin. Can Med Assoc J [Internet]. 2013 [cited 2018 Dec 15];185:E506–E506. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23128284

Alp R, Citil M, Uzun M, Alp S, Topcu B, Uzlu E, Erdogan HM. Effects of therapeutic doses of Pregabalin on QTc interval in conscious rabbits. Eur Rev Med Pharmacol Sci [Internet]. [cited 2018 Dec 15];12:223–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18727453

•• Chen D, Lal R, Zomorodi K, Atluri H, Ho J, Luo W, Tovera J, Bonzo D, Cundy K. Evaluation of gabapentin enacarbil on cardiac repolarization: a randomized, double-blind, placebo- and active-controlled, crossover thorough QT/QTc study in healthy adults. Clin Ther [Internet]. 2012 [cited 2019 Feb 28];34:351–362.e3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22325733 . This study demonstrates a lack of effect on QTc interval for the enacarbil formulation of gabapentin.

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Schiavo A, Stagnaro FM, Salzano A, Marra AM, Bobbio E, Valente P, Grassi S, Miniero M, Arcopinto M, Matarazzo M, Napoli R, Cittadini A. Pregabalin-induced first degree atrioventricular block in a young patient treated for pain from extrapulmonary tuberculosis. Monaldi Arch Chest Dis [Internet] 2017 [cited 2019 Jan 28];87:838. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29424197 , 87

Aksakal E, Bakirci EM, Emet M, Uzkeser M. Complete atrioventricular block due to overdose of pregabalin. Am J Emerg Med [Internet]. 2012 [cited 2019 Jan 29];30:2101.e1–4. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0735675712000897

• Ortiz de Landaluce L, Carbonell P, Asensio C, Escoda N, López P, Laporte JR Gapentin and pregabalin and risk of atrial fibrillation in the elderly: a population-based cohort study in an electronic prescription database. Drug Saf [Internet]. 2018 [cited 2019 Feb 28];41:1325–1331. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29956217 . This article reports a significant association of gabapentin and pregabalin to risk of atrial fibrillation. While further research should validate this association and elucidate its mechanism, clinicians should remain cognizant of the potential for these agents to contribute to the development of atrial fibrillation in older adults.

Diaper A, Rich AS, Wilson SJ, Craig K, Dourish CT, Dawson GR, Nutt DJ, Bailey JE. Changes in cardiovascular function after venlafaxine but not pregabalin in healthy volunteers: a double-blind, placebo-controlled study of orthostatic challenge, blood pressure and heart rate. Hum Psychopharmacol Clin Exp [Internet]. 2013 [cited 2019 Jan 29];28:562–575. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23955418

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Behuliak M, Bencze M, Polgárová K, Kuneš J, Vaněčková I, Zicha J. Hemodynamic response to gabapentin in conscious spontaneously hypertensive rats. Hypertension [Internet]. 2018 [cited 2019 Jan 28];72:676–685. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30354755