Liver injury induced by concomitant use of metronidazole and ibuprofen
10.3760/cma.j.cn114015-20200320-00300
- VernacularTitle:甲硝唑与布洛芬联用致肝损伤
- Author:
Hongmei ZHANG
1
;
Xu TIAN
;
Yangfang HE
;
Wei ZHOU
Author Information
1. 吉林大学第一医院药学部，长春 130021
- Publication Type:Journal Article
- Keywords:
Metronidazole;
Ibuprofen;
Chemical and drug induced liver injury
- From:
Adverse Drug Reactions Journal
2020;22(12):705-706
- CountryChina
- Language:Chinese
-
Abstract:
A 35-year-old female patient received metronidazole sustained release tablets 0.75 g once daily and cefuroxime axetil 0.25 g twice daily after hysteroscopy curettage for infection. Because of postoperative fever and cough, she took ibuprofen granules 0.2 g each time orally by herself. After 3 days of treatments with metronidazole sustained release tablets and cefuroxime axetil and 4 times of ibuprofen granules, the patient developed right upper abdominal pain and dark urine. On the next day, the patient′s right upper abdominal pain was aggravated progressively, she developed soy sauce-like urine and yellowish skin and sclera. Laboratory tests showed alanine aminotransferase (ALT) 403 U/L, aspartate aminotransferase (AST) 248 U/L, gamma glutamyl transpeptidase (γ-GT) 327 U/L, alkaline phosphatase (ALP) 58 U/L, total bilirubin (TBil) 72.5 μmol/L, and direct bilirubin (DBil) 41.5 μmol/L. Liver injury induced by concomitant use of metronidazole and ibuprofen was considered. Metronidazole and ibuprofen were stopped and liver-protective and symptomatic treatments were given. Cefuroxime axetil was continued. Three days later, the patient′s abdominal pain disappeared gradually, her urine color became lighter, the yellow staining of skin and sclera was alleviated, and the respiratory symptoms were improved. Nine days later, the reexamination of liver function showed ALT 88 U/L, AST 35 U/L, γ-GT 185 U/L, ALP 52 U/L, TBil 19.6 μmol/L, and DBil 9.7 μmol/L.
