Is Pregabalin associated with oliguria?

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Last updated: February 14, 2025View editorial policy

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From the FDA Drug Label

Infrequent: Abnormal ejaculation, Albuminuria, Amenorrhea, Dysmenorrhea, Dysuria, Hematuria, Kidney calculus, Leukorrhea, Menorrhagia, Metrorrhagia, Nephritis, Oliguria, Urinary retention, Urine abnormality; Oliguria is listed as an infrequent adverse reaction in the urogenital system, occurring in 1/100 to 1/1000 patients, according to the definitions provided in the drug label 1.

  • Key points:
    • Oliguria is an adverse reaction associated with pregabalin.
    • The frequency of oliguria is infrequent, occurring in 1/100 to 1/1000 patients.

From the Research

Introduction

Pregabalin is a medication used to treat various conditions, including epilepsy, neuropathic pain, and anxiety disorders. The question of whether pregabalin is associated with oliguria, a condition characterized by decreased urine production, is an important one for healthcare providers.

Mechanism of Action

Pregabalin works by binding to the alpha2-delta subunit of voltage-gated calcium channels in the central nervous system, which reduces the release of excitatory neurotransmitters 2, 3. This mechanism of action does not directly suggest a link to oliguria.

Pharmacokinetics

Pregabalin is excreted virtually unchanged by the kidneys, with a mean elimination half-life of 6.3 hours 2. This suggests that pregabalin may accumulate in patients with renal insufficiency, potentially leading to adverse effects. However, there is no direct evidence to suggest that pregabalin causes oliguria.

Adverse Effects

Several studies have reported adverse effects associated with pregabalin, including dizziness, vertigo, and edema 4, 5, 6. While these effects may be related to fluid balance, they do not directly indicate a link to oliguria.

Renal Considerations

Pregabalin is renally cleared, and dose adjustment may be necessary in patients with renal insufficiency 2, 4. This suggests that pregabalin may have a greater impact on patients with pre-existing renal conditions, but does not directly imply a link to oliguria.

Conclusion

Based on the available evidence, there is no clear association between pregabalin and oliguria. However, patients with renal insufficiency may require dose adjustment, and healthcare providers should be aware of the potential for adverse effects related to fluid balance.

Treatment Considerations

  • Pregabalin dosing should be adjusted in patients with renal insufficiency
  • Patients should be monitored for adverse effects related to fluid balance, such as edema
  • Alternative treatments may be considered in patients with a history of renal disease or oliguria
  • Dosing regimens should be individualized to minimize the risk of adverse effects, with a typical starting dose of 150 mg/day and titration as needed

Caveats

  • Pregabalin may accumulate in patients with renal insufficiency, potentially leading to adverse effects
  • Patients with pre-existing renal conditions may be at greater risk for adverse effects related to fluid balance
  • Healthcare providers should carefully monitor patients for signs of oliguria or other renal complications when prescribing pregabalin.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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