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Fatal fulminant hepatitis associated with bromfenac use
J M Rabkin1, M J Smith, S L Orloff
1Department of Surgery, Oregon Health Sciences University, and Portland Veterans Affairs Medical Center, 97201, USA. rabkinj@ohsu.edu
The Annals of Pharmacotherapy
|September 24, 1999
Summary
Fulminant hepatic failure, a severe liver condition, was linked to bromfenac, a nonsteroidal anti-inflammatory drug. This adverse event highlights potential risks associated with phenyl acetate analogs.
Area of Science:
- Hepatology
- Pharmacology
- Toxicology
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for pain management.
- Bromfenac, a phenyl acetate derivative NSAID, was prescribed for arthritic pain.
- Patient had no prior history of chronic liver disease.
Observation:
- A 60-year-old woman developed fulminant hepatic failure after three months of bromfenac use.
- Her liver function tests were normal before initiating bromfenac.
- Deterioration included hepatic encephalopathy and worsening liver function despite medical care.
Findings:
- The case suggests an idiosyncratic hepatotoxic reaction to bromfenac.
- Prolonged use of bromfenac was associated with severe liver injury.
- The patient experienced progressive hepatic and renal dysfunction.
Implications:
- This case contributed to understanding the hepatotoxicity of phenyl acetate NSAIDs.
- Serious adverse events associated with bromfenac led to its market withdrawal.
- Highlights the importance of monitoring liver function during NSAID therapy.