Hepatitis associated with low-dose venlafaxine for postmenopausal vasomotor symptoms.
Ann Pharmacother
; 40(2): 323-7, 2006 Feb.
Article
en En
| MEDLINE
| ID: mdl-16418323
ABSTRACT
OBJECTIVE:
To report a case of drug-induced hepatitis associated with low-dose venlafaxine. CASESUMMARY:
A 60-year-old white woman receiving venlafaxine 75 mg daily for vasomotor symptoms presented after one month of therapy with nonspecific complaints, including abdominal pain. A series of diagnostic and laboratory tests revealed an enlarged liver and elevated alanine aminotransferase (ALT) up to 372 U/L, aspartate aminotransferase (AST) up to 99 U/L, gamma-glutamyltransferase (GGT) up to 962 U/L, and alkaline phosphatase up to 758 U/L. All potential hepatotoxic medications were discontinued. Within one week after stopping venlafaxine, her liver function test results showed marked improvement. Almost 4 weeks after discontinuing therapy, venlafaxine 37.5 mg was reinitiated. Her ALT, AST, GGT, and alkaline phosphatase again increased to 269, 49, 256, and 263 U/L, respectively, 6 days after resuming therapy. Upon discontinuation of venlafaxine, her liver function abnormalities resolved.DISCUSSION:
This case is significant due to the severity of symptoms and consequent liver function test results involved in diagnosing drug-induced hepatitis. It is also remarkable because of the hepatotoxicity that occurred initially and on rechallenge with low-dose venlafaxine. The hepatotoxic effects of venlafaxine have been characterized as rare and idiosyncratic. The Naranjo probability scale revealed that the adverse drug event was probable.CONCLUSIONS:
Venlafaxine therapy can lead to drug-induced hepatitis, even when used at low doses. Clinicians should be aware of this possible adverse effect of venlafaxine therapy and monitor patients closely after initiation of therapy.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Posmenopausia
/
Sofocos
/
Ciclohexanoles
/
Enfermedad Hepática Inducida por Sustancias y Drogas
Tipo de estudio:
Diagnostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Ann Pharmacother
Asunto de la revista:
FARMACOLOGIA
/
TERAPIA POR MEDICAMENTOS
Año:
2006
Tipo del documento:
Article
País de afiliación:
Estados Unidos