Severe liver injury induced by metformin hydrochloride sustained release tablets
10.3760/cma.j.cn114015-20210826-00940
- VernacularTitle:盐酸二甲双胍缓释片致重度肝损伤
- Author:
Jingling WU
1
;
Xiaojun CHEN
Author Information
1. 厦门市第五医院药剂科，厦门 361101
- Publication Type:Journal Article
- Keywords:
Metformin;
Chemical and drug induced liver injury;
Drug-related side and adverse reactions
- From:
Adverse Drug Reactions Journal
2022;24(5):264-265
- CountryChina
- Language:Chinese
-
Abstract:
A 50-year-old female patient with diabetes mellitus took metformin hydrochloride sustained release tablets (metformin) 0.5 g once daily orally by herself for 3 courses. The patient had vomiting or diarrhea after each medication. At the nearest treatment, the patient took the drug for 4 days and yellowish skin and sclera and fatigue appeared 3 days after drug withdrawal. Laboratory tests showed alanine aminotransferase (ALT) 422 U/L, aspartate aminotransferase (AST) 166 U/L, alkaline phosphatase (ALP) 276 U/L, γ-glutamyl transpeptidase (γ-GT) 369 U/L, total bilirubin (TBil) 383.0 μmol/L, and direct bilirubin (DBil) 269.9 μmol/L. After excluding the causes of viral hepatitis, autoimmune liver disease, and obstructive jaundice, liver injury caused by metformin was considered. Then metformin was stopped and treatments with magnesium isoglycyrrhizinate and Yinzhihuang granules (茵栀黄颗粒) were given. After 11 days of treatments, the above symptoms disappeared and the fatigue was alleviated. Laboratory tests showed ALT 225 U/L, AST 89 U/L, ALP 215 U/L, γ-GT 291 U/L, TBil 86.1 μmol/L, and DBil 44.6 μmol/L.
