Has urinary retention be reported as an adverse effect of pregabalin?/nThe question concerns a 45-y

Fråga: Has urinary retention be reported as an adverse effect of pregabalin?

The question concerns a 45-year-old man with chronic back pain and a history of Citodon overuse. Treatment with pregabalin was started in February and the dose has slowly been increased up to 75 mg + 150 mg. The patient was, in the end of April, admitted with urinary retention amounting to 2 liters. The patient now has a catheter.

Sammanfattning: Pregabalin may, in rare cases, cause urinary retention.

Svar: Urinary retention may be an anticholinergic adverse effect usually associated with use of high doses of anticholinergic drugs (1). Other anticholinergic adverse effects, such as dry mouth, constipation have been reported as common adverse effects of pregabalin (2). This indicates that there is a theoretical risk of urinary retention.

In the Swedish adverse drug reactions register there are four case reports of urinary retention as an adverse effect of pregabalin. In all of these cases urinary retention has appeared within two weeks after therapy has been started. In one patient the symptoms appeared after only one day of treatment. In three of these cases the symptoms disappeared after withdrawal, the fourth patient continued using pregabalin (3). In Vigibase only 59 out of 31645 reports concerns urinary retention (4). No other reports have been found in the literature.

In the present case withdrawal of pregabalin should be considered. We recommend a report of this case to the regional adverse drug reaction monitoring centre. Simonsen Terje, Aarbacke Jarle, Hasselström Jan (2002) Illustrerad farmakologi, sjukdomar och behandling, del 2. Stockholm: Natur & Kultur. Scientific discussion LYRICA. EMEA 2004. Swedis 2009-05-15 Vigibase 2009-05-15