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Nimesulide-induced hepatotoxicity and fatal hepatic failure
1Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore. mhyhui@singnet.com.sg
Singapore Medical Journal
|June 1, 2007
Summary
Non-steroidal anti-inflammatory drugs (NSAIDs), like nimesulide, can cause severe liver injury. This report details three cases of acute hepatitis and one fatality linked to nimesulide use.
Area of Science:
- Pharmacology
- Hepatology
- Drug Safety
Background:
- Non-steroidal anti-inflammatory drugs (NSAIDs) and cyclo-oxygenase-2 (COX-2) inhibitors are widely used for pain and inflammation.
- Hepatotoxicity is a rare but serious adverse effect associated with NSAIDs, leading to market withdrawals.
- Nimesulide, a COX-2 preferential NSAID, has been implicated in hepatic failure, particularly in European reports.
Observation:
- This study reports three Asian patients who developed acute hepatitis after nimesulide prescription.
- One patient experienced fatal fulminant hepatic failure.
- Clinical presentation included acute liver injury following nimesulide administration.
Findings:
- Nimesulide can induce severe hepatotoxicity, including fatal outcomes.
- The occurrence of nimesulide-induced liver injury is not limited to European populations.
- Prompt recognition and management of NSAID-induced liver injury are crucial.
Implications:
- Healthcare providers should exercise caution when prescribing nimesulide, especially in Asian populations.
- Further pharmacovigilance is needed to monitor nimesulide's safety profile globally.
- Awareness of nimesulide's potential for severe hepatotoxicity is essential for patient safety and risk management.
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