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Severe liver dysfunction possibly caused by the combination of interferon beta-1b therapy and melilot (sweet clover)

S Tamura1, Y Warabi, S Matsubara

  • 1Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.

Journal of Clinical Pharmacy and Therapeutics
|May 31, 2012
PubMed
Abstract

Insights

A patient with multiple sclerosis experienced severe liver damage after taking a melilot supplement and interferon beta-1b injections. Discontinuing both resolved the liver issues, suggesting avoidance of this supplement during interferon therapy.

Area of Science:

  • Hepatology
  • Neurology
  • Pharmacology

Background:

  • Interferon beta (IFNB)-1b is a common treatment for multiple sclerosis (MS).
  • MS patients may experience mild liver dysfunction with IFNB-1b therapy.
  • Melilot (sweet clover) supplements, containing coumarin, are sometimes used by the general population.

Observation:

  • A 23-year-old woman with MS was treated with IFNB-1b while taking a daily melilot supplement (10 mg coumarin).
  • Within 14 days of IFNB-1b injections, her liver enzymes (AST and ALT) significantly elevated.
  • Upon cessation of IFNB-1b and the melilot supplement, liver enzymes normalized.

Findings:

  • The patient tolerated weekly IFNB-1a injections without the supplement, showing only a minor AST elevation.
  • This suggests a potential interaction between IFNB-1b and melilot supplement causing severe hepatotoxicity.
  • The coumarin content in melilot may be a contributing factor to the liver dysfunction.

Implications:

  • Patients with MS undergoing interferon therapy should be cautious about concurrent use of melilot supplements.
  • The potential for severe liver dysfunction necessitates careful consideration of supplement use in patients on interferon treatment.
  • Further research is warranted to elucidate the interaction between interferon therapy and herbal supplements like melilot.

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