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Ketoconazole-induced liver damage

J A Findor1, J A Sorda, E B Igartua

  • 1División de Gastroenterología, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Argentina.

Medicina
|August 26, 1998
PubMed
Summary
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Ketoconazole can cause severe liver damage, leading to fatalities in some cases. Regular monitoring is crucial to detect early signs of hepatotoxicity during antifungal therapy.

Area of Science:

  • Pharmacology
  • Hepatology
  • Mycology

Background:

  • Ketoconazole is a widely used antifungal medication.
  • Liver damage (hepatotoxicity) is a known, albeit rare, adverse effect of ketoconazole.
  • This study examines clinical cases of ketoconazole-induced liver injury.

Observation:

  • Five patients (4 female, 1 male) developed liver damage while on ketoconazole (400 mg/day) for mycoses.
  • Hepatotoxicity signs appeared around four weeks into therapy in female patients.
  • Two patients experienced fatal outcomes, one with fulminant liver failure and massive necrosis, the other with submassive necrosis.

Findings:

  • Cholestasis was a significant finding in four out of five cases.
  • Biochemical markers of biliary stasis persisted for months in surviving patients.

Related Experiment Videos

  • Continued ketoconazole use despite adverse effects was noted in fatal cases.
  • Implications:

    • Early and repeated monitoring for liver function is essential during ketoconazole treatment.
    • Healthcare providers should be vigilant for signs of hepatotoxicity.
    • Risk-benefit assessment is critical, especially in prolonged ketoconazole therapy.