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Gabapentin is an anti-convulsant that is also used off-label to treat neuropathic pain. It is not metabolized by the liver, and there have been few reports of hepatotoxity associated with it. We present a rare case of gabapentin-induced hepatotoxicity occurring in a young male. Gapentin has no appreciable liver metabolism, but suspected cases of gabapentin-induced hepatotoxicity have been reported. Even high doses of gabapentin (400mg/kg) for 30 days do not produce deleterious adverse effects on the liver or haematological parameters. Gabapentin is generally considered safe for the liver, but rare cases of liver damage have been reported. Gabapentin, a medication primarily used to treat nerve pain and seizures, has gained popularity for its effectiveness and relatively mild side effects. Pregabalin is an inhibitor of neuronal activity used for therapy of painful neuropathy and as an anticonvulsant. Therapy with pregabalin is not associated with serum aminotransferase elevations, and clinically apparent liver injury from pregabalin has been reported but appears to be quite rare. A drug-induced liver injury is one of the most common causes of acute liver failure. While acetaminophen is the most common etiology, other offending medications include amoxicillin-clavulanic acid, amiodarone, isoniazid, and fluoroquinolones to name a few. Gabapentin, a gamma-aminobutyric acid (GAB Herein, we report a gabapentin-induced hepatocellular injury in a patient without another identifiable cause for acute liver injury. Discontinuing gabapentin resulted in rapid reversal improvement in hepatocellular injury. Keywords: gabapentin, hepatotoxicity, drug-induced liver injury. Key takeaways: Gabapentin (Neurontin, Horizant, Gralise) usually isn’t bad for your liver or kidneys. In most cases, it has no harmful effect on these organs. In rare instances, gabapentin can cause DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome. Gabapentin enacarbil and gabapentin are associated with a low rate of transient serum enzyme elevations during treatment and with rare instances of clinically apparent liver injury. Therapy with gabapentin is not associated with serum aminotransferase elevations, but several cases of clinically apparent liver injury from gabapentin have been reported. Gabapentin is a unique anticonvulsant that is used as adjunctive therapy in management of epilepsy and for neuropathic pain syndromes. DRESS was common with liver injury caused by lamotrigine, phenytoin, and carbamazepine, but not valproate or gabapentin. Liver injury severity was moderate to severe in the majority: five died, and three underwent liver transplantation (OLT). LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Show details Drug Records < Prev Next > Agents Included in LiverTox by Drug Class Last Update: January 30, 2025. Anticonvulsant medications include many agents that have been incriminated in causing idiosyncratic drug induced liver disease. Indeed, several commonly used anticonvulsants (phenytoin, valproate, carbamazepine) are consistently ranked in the top causes of clinically apparent drug induced liver injury and are frequently listed in causes of drug induced acute liver failure. Because of the Am J Ther. 2022 Nov-Dec;29 (6):e751-e752. doi: 10.1097/MJT.0000000000001208. Epub 2020 Jun 5. 1 Internal Medicine, SUNY Upstate Medical University, Syracuse, NY. 2 Gastroenterology, SUNY Upstate Medical University, Syracuse, NY. LiverTox consists of three major components: (1) an introductory and background section, (2) separate records on the hepatotoxicity of individual drugs, and (3) an interactive section that allows for submission and assessment of cases. The introductory and background section includes an overview and detailed discussion of the problem of drug-induced liver injury: its frequency, major causes LiverTox is a web-based resource for information on drug-induced liver injury from prescription and OTC drugs, and complementary and alternative medicines. Introduction: We are reporting a case of drug induced liver injury (DILI) secondary to gabapentin therapy with risk factors for underlying non-alcoholic fatty liver disease (NAFLD). Case Description/Methods: A 56-year-old male with hypertension, hyperlipidemia, diabetes with neuropathy, obesity, and chronic kidney disease stage 3 presented as an outside hospital (OSH) transfer for evaluation LiverTox ® provides regularly updated, unbiased and easily accessed information on the diagnosis, cause, frequency, clinical patterns and management of liver injury attributable to prescription and nonprescription medications and selected herbal and dietary supplements. Gabapentin enacarbil is a long acting form of gabapentin that is used for restless leg syndrome and for painful postherpetic neuropathy. Gabapentin enacarbil and gabapentin are associated with a low rate of transient serum enzyme elevations during treatment and with rare instances of clinically appa Letters to the Editor Gabapentin-Induced Liver Toxicity Chahal, Japjot MD 1; Arif, Muhammad Osman MD 2; Achufusi, Ted George MD 1 Author Information LiverTox<sup>®</sup> provides regularly updated, unbiased and easily accessed information on the diagnosis, cause, frequency, clinical patterns and management of liver injury attributable to prescription and nonprescription medications and selected herbal and dietary supplements. The LiverTox site i
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