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Flutamide-induced liver failure.

S Møller1, P Iversen, M B Franzmann

  • 1Department of Medicine B259, University of Copenhagen, Denmark.

Journal of Hepatology
|May 1, 1990
PubMed
Summary
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Severe liver damage occurred in two prostate cancer patients treated with flutamide, a non-steroidal antiandrogen. Symptoms reversed after stopping flutamide, indicating a potentially reversible drug interaction.

Area of Science:

  • Hepatology
  • Oncology
  • Pharmacology

Background:

  • Metastatic prostatic cancer is often treated with hormonal therapies.
  • Non-steroidal antiandrogens like flutamide are used in combination with luteinizing hormone-releasing hormone analogues.
  • Hepatotoxicity is a known, though typically asymptomatic, adverse effect of flutamide.

Observation:

  • Two patients with metastatic prostate cancer developed clinically significant liver failure during flutamide treatment.
  • One patient presented with severe hepatic insufficiency, jaundice, ascites, and hepatic coma.
  • The second patient exhibited jaundice with a biochemical cholestatic pattern.

Findings:

  • Flutamide discontinuation led to the reversal of liver failure in the severe case.

Related Experiment Videos

  • Hepatotoxicity from flutamide can manifest as severe clinical liver failure, not just elevated transaminases.
  • Morphological liver lesions and clinical presentation suggest a reversible interaction with hepatocyte metabolic processes.

    • Implications:

    • Clinicians should monitor for severe hepatotoxicity in patients receiving flutamide, even with prior reports of only asymptomatic elevations.
    • Early recognition and discontinuation of flutamide may prevent severe liver damage.
    • Further investigation into the mechanisms of flutamide-induced hepatotoxicity is warranted.