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The hepatic safety profile of duloxetine: a review
Roger S McIntyre1, Zilomi D Panjwani, Ha T Nguyen
1University Health Network, Mood Disorders Psychopharmacology Unit, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada. roger.mcintyre@uhn.on.ca
Background:
Hepatotoxicity related to the use of duloxetine resulted in rewording of the US product insert.
Objective:
To characterize the hepatic safety profile of duloxetine.
Methods:
We conducted a PubMed search of all English-language articles published between January 1990 and December 2007 and contacted the manufacturer (Eli Lilly, Inc.).
Results:
Elevations of alanine aminotransferase to three times the upper limit of normal occurs in 0.9-1.7% of duloxetine-treated patients versus 0.0-0.3% of placebo-treated patients. Hepatocellular, cholestatic and mixed hepatocellular-cholestatic forms of hepatic injury have been described.
Conclusion:
Duloxetine does not appear to pose a greater hazard for hepatic toxicity when compared to other conventional antidepressants. Systematic monitoring of liver aminotransferases does not appear to be warranted with routine duloxetine use.
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