A 63-year-old male on hemodialysis, presented to the emergency department with bilateral thigh pain and weakness. He had been taking pregabalin 50mg once daily for uremic pruritus at the local dialysis center. He recently visited the dermatology clinic for worsening symptoms and added 75mg of pregabalin to his daily dose, for a total of 125 mg per day. After three days, he developed bilateral thigh tenderness and weakness. Laboratory findings showed elevated levels of creatinine kinase at 17,036 U/L (reference range: 5–217 U/L) and myoglobin > 20,000 ng/mL (reference range: 3–110 ng/mL). To assess the extent of muscle damage, the 99mTc-DPD bone scintigraphy was performed and revealed that diffuse muscular tracer uptake on bilateral upper extremities and thighs (Fig. 1), suggesting rhabdomyolysis. Daily hemodialysis with a medium cut-off membrane was performed for one week to relieve symptoms. His lower extremity pain and weakness gradually improved and creatinine kinase and myoglobin levels dropped over 194 U/L and 659.8 ng/mL, respectively.