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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
Summary
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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