Open AccessMontelukast induced acute hepatocellular liver injury
Author(s) -
Anand Harugeri,
G Parthasarathi,
J. N. Sharma,
George D’Souza,
Madhan Ramesh
Publication year - 2009
Publication title -
journal of postgraduate medicine/journal of postgraduate medicine
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.405
H-Index - 52
eISSN - 0972-2823
pISSN - 0022-3859
DOI - 10.4103/0022-3859.52850
Subject(s) - montelukast , medicine , liver injury , jaundice , gastroenterology , formoterol , alkaline phosphatase , budesonide , bilirubin , abdominal pain , asthma , biochemistry , chemistry , enzyme
A 46-year-old male with uncontrolled asthma on inhaled albuterol and formoterol with budesonide was commenced on montelukast. He developed abdominal pain and jaundice 48 days after initiating montelukast therapy. His liver tests showed an increase in serum total bilirubin, conjugated bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase. The patient was evaluated for possible non-drug related liver injury. Montelukast was discontinued suspecting montelukast induced hepatocellular liver injury. Liver tests began to improve and returned to normal 55 days after drug cessation. Causality of this adverse drug reaction by the Council for International Organizations of Medical Sciences or Roussel Uclaf Causality Assessment Method (CIOMS or RUCAM) and Naranjo's algorithm was 'probable'. Liver tests should be monitored in patients receiving montelukast and any early signs of liver injury should be investigated with a high index of suspicion for drug induced liver injury.