Gabapentin diabetic neuropathy

Peripheral neuropathy is also common with advanced CKD and is typically indistinguishable from other types of neuropathy (e.g., diabetic neuropathy). Symptoms are often uncomfortable for the patient and prompt many clinicians to initiate pharmacologic therapy in an attempt to reduce these symptoms. Tricyclic antidepressants (e.g., amitriptyline) and anticonvulsants (e.g., phenytoin and gabapentin) may have some benefit in alleviating symptoms of neuropathy however, risks and benefits must be considered for agents... 

Pregabalin is another second-generation anticonvulsant that has recently obtained FDA approval for treatment of neurogenic pain, and several randomized placebo controlled studies have shown that this compound is efficacious in the treatment of painful diabetic neuropathy [32]. Doses between 300 and 600 mg/day have shown effect already apparent after 1 week of treatment. There are few clinically important drug interactions as there is no interference with the cytochrome 450 system. This compound requires minimal dose titration and seems easy to use. Side effects to gabapentin and pregabalin include drowsiness, dizziness and peripheral edema. 

Musculoskeletal Gabapentin can rarely cause a myopathy and rhabdomyolysis. Myoglobinuria, causing acute renal insufficiency, has been described in a patient with painful diabetic neuropathy [122 ]. 

Bilgir O, Calan M, Bilgir F, Kebap ilar L, YUksel A, Yildiz Y, Sari I. Gabapentin-induced rhabdomyolysis in a patient with diabetic neuropathy. Intern Med 2009 48 (12) 1085-7. 

D.F. Sahagian, G.A. Randomized double blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain. Arch. Intern. Med. 1999, 159 (16), 1931-1937. 

Backonja M, Beydoun A, Edwards KR, et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus a randomized controlled trial. JAMA 1998 280(21) 1831-1836. 

Sandercock D, Cramer M, Wu J, Chiang YK, Biton V, Heritier M. Gabapentin extended release for the treatment of painful diabetic peripheral neuropathy efficacy and tolerability in a double-blind, randomized, controlled clinical trial. Diabetes Care 2009 32(2) e20. 

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