Journal article
Hepatitis Associated with Low-Dose Venlafaxine for Postmenopausal Vasomotor Symptoms
The Annals of pharmacotherapy, Vol.40(2), pp.323-327
02/2006
DOI: 10.1345/aph.1G339
PMID: 16418323
Abstract
Objective: To report a case of drug-induced hepatitis associated with low-dose venlafaxine.
Case summary: A 60-year-old white woman receiving venlafaxine 75 mg daily for vasomotor symptoms presented after one month of therapy with nonspecific complaints, including abdominal pain. A series of diagnostic and laboratory tests revealed an enlarged liver and elevated alanine aminotransferase (ALT) up to 372 U/L, aspartate aminotransferase (AST) up to 99 U/L, gamma-glutamyltransferase (GGT) up to 962 U/L, and alkaline phosphatase up to 758 U/L. All potential hepatotoxic medications were discontinued. Within one week after stopping venlafaxine, her liver function test results showed marked improvement. Almost 4 weeks after discontinuing therapy, venlafaxine 37.5 mg was reinitiated. Her ALT, AST, GGT, and alkaline phosphatase again increased to 269, 49, 256, and 263 U/L, respectively, 6 days after resuming therapy. Upon discontinuation of venlafaxine, her liver function abnormalities resolved.
Discussion: This case is significant due to the severity of symptoms and consequent liver function test results involved in diagnosing drug-induced hepatitis. It is also remarkable because of the hepatotoxicity that occurred initially and on rechallenge with low-dose venlafaxine. The hepatotoxic effects of venlafaxine have been characterized as rare and idiosyncratic. The Naranjo probability scale revealed that the adverse drug event was probable.
Conclusions: Venlafaxine therapy can lead to drug-induced hepatitis, even when used at low doses. Clinicians should be aware of this possible adverse effect of venlafaxine therapy and monitor patients closely after initiation of therapy.
Details
- Title: Subtitle
- Hepatitis Associated with Low-Dose Venlafaxine for Postmenopausal Vasomotor Symptoms
- Creators
- Beth Bryles Phillips - Ambulatory Care, University of Iowa Hospitals and Clinics; and Assistant Professor (clinical), Division of Clinical and Administrative Pharmacy, University of Iowa College of Pharmacy, Iowa City, IARachel R Digmann - University of Iowa Hospitals and Clinics; now, Clinical Pharmacy Specialist, Kaiser Permanente, Denver, COM Gwen Beck - Department of Internal Medicine, College of Medicine, University of Iowa, and University of Iowa Hospitals and Clinics
- Resource Type
- Journal article
- Publication Details
- The Annals of pharmacotherapy, Vol.40(2), pp.323-327
- DOI
- 10.1345/aph.1G339
- PMID
- 16418323
- ISSN
- 1060-0280
- eISSN
- 1542-6270
- Language
- English
- Date published
- 02/2006
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984001148802771
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