From the Guidelines
Gabapentin should not be taken by patients with fatty liver disease, as it is not recommended for use in patients with hepatic pruritus according to the British Association of Dermatologists' guidelines 1. The guidelines explicitly state that gabapentin should not be used in patients with hepatic pruritus, which is a common symptom of fatty liver disease. Instead, other treatments such as rifampicin, cholestyramine, and sertraline are recommended as first-line, second-line, and third-line treatments, respectively 1. Some key points to consider when managing patients with fatty liver disease and pruritus include:
- Monitoring liver function and adjusting treatment accordingly 1
- Considering alternative treatments that are safer and more effective for patients with fatty liver disease 1
- Informing patients about the potential risks and benefits of different treatments and involving them in the decision-making process 1 It is essential to prioritize the patient's safety and well-being when managing fatty liver disease and pruritus, and to choose treatments that are evidence-based and recommended by reputable guidelines 1.
From the Research
Gabapentin and Fatty Liver Disease
- There is limited research directly addressing the use of gabapentin in patients with fatty liver disease.
- A study from 2013 2 investigated the chronic effect of gabapentin on liver function in adult male rats, finding that at therapeutic doses, gabapentin is safer regarding liver function and hepatocellular damage compared to other antiepileptic drugs.
- However, a case report from 2018 3 described a patient experiencing gabapentin-induced hepatocellular injury, highlighting the potential for liver damage in some individuals.
- Other studies, such as those from 2011 4 and 2017 5, focused on the efficacy and safety of gabapentin for chronic neuropathic pain, without specifically addressing its use in patients with fatty liver disease.
- A 2022 study 6 examined the risk of adverse events associated with higher-dose gabapentinoids in older adults with chronic kidney disease, but did not directly address fatty liver disease.
Key Considerations
- The current evidence does not provide clear guidance on the safety of gabapentin in patients with fatty liver disease.
- Patients with fatty liver disease should be closely monitored for signs of liver damage if prescribed gabapentin.
- Healthcare providers should weigh the potential benefits of gabapentin against the risks of liver damage and consider alternative treatments if necessary.