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Clopidogrel-induced hepatotoxicity and fever

Jennifer A Ng1, Neil Goldberg, Mohammad J Tafreshi

  • 1Department of Pharmacy, Banner Estrella Medical Center, Pheonix, Arizona 858037, USA. jennifer.ng@banner.health.com

Pharmacotherapy
|August 2, 2006
PubMed

Insights

Clopidogrel can cause fever and elevated liver enzymes in some patients. Discontinuation is recommended if hepatotoxicity is suspected, with ticlopidine as a potential alternative.

Area of Science:

  • Pharmacology
  • Hepatology
  • Cardiology

Background:

  • Clopidogrel is a widely used antiplatelet medication.
  • Percutaneous coronary intervention (PCI) often involves antiplatelet therapy.
  • Drug-induced liver injury is a potential adverse effect of various medications.

Purpose of the Study:

  • To report a case of clopidogrel-induced hepatotoxicity.
  • To highlight the importance of monitoring liver function in patients taking clopidogrel.
  • To suggest management strategies for suspected clopidogrel-related liver injury.

Main Methods:

  • Case report of a 59-year-old woman.
  • Clinical observation of symptoms and laboratory values.
  • Assessment following drug discontinuation and rechallenge.

Main Results:

  • The patient developed fever and elevated hepatic enzymes shortly after initiating clopidogrel.
  • Symptoms resolved upon clopidogrel cessation and recurred upon rechallenge.
  • Liver enzyme levels returned to normal after discontinuing the drug.

Conclusions:

  • Clopidogrel can be associated with drug-induced liver injury.
  • Monitoring for fever and elevated liver enzymes is crucial for patients on clopidogrel.
  • Discontinuation of clopidogrel and consideration of alternatives like ticlopidine are recommended for hepatotoxicity.

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