Spironolactone Hepatitis in Primary Hyperaldosteronism

Shuck, John; Shen, Shiao; Owensby, Loren C.; Leftik, Martin; Cucinell, Samuel A.

doi:10.7326/0003-4819-95-6-708

Cited by 10 publications

(2 citation statements)

References 3 publications

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“…Although spironolactone is not used as an antihypertensive agent, extensive experience with its use in chronic liver disorders has not revealed significant hepatotoxicity. However, when used as an antiandrogen in persons with diffuse alopecia or primary hyperaldosteronism, [88][89][90] spironolactone can occasionally cause a significant increase in aminotransferase levels. It may be recalled that other antiandrogens (flutamide, cyproterone) are recognized causes of acute hepatocellular injury.…”

Section: Aldosterone Receptor Antagonist (Spironolactone)mentioning

confidence: 99%

Hepatotoxicity of Commonly Used Drugs: Nonsteroidal Anti-Inflammatory Drugs, Antihypertensives, Antidiabetic Agents, Anticonvulsants, Lipid-Lowering Agents, Psychotropic Drugs

Chitturi¹,

George²

2002

Semin Liver Dis

194

106

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Hepatotoxic adverse drug reactions have contributed to the decline of many promising therapies, even among mainstream medication classes (bromfenac and troglitazone are recent examples). The spectrum of nonsteroidal anti-inflammatory drug-related liver toxicity continues to expand, with reports in children, interactive toxicity in persons with hepatitis C, and recognition of the toxicity of both the preferential and selective cyclooxygenase-2 inhibitors. Of the antihypertensive agents, methyldopa is now rarely prescribed and adverse effects are reported infrequently, whereas cases of liver injury associated with the angiotensin receptor and converting enzyme inhibitors are increasingly reported. Of the antidiabetic agents, acarbose, gliclazide, metformin, and human insulin have been implicated in causing liver injury. To date, the newer thiazolidinediones do not appear to share the hepatotoxic potential of troglitazone, although a few reports of acute hepatitis have accrued. Although liver injury has been associated with the "statins," the frequency of such toxicity is lower than that of the background population and the value of biochemical monitoring remains unproved. Newer concepts in anticonvulsant hepatotoxicity have been the recognition of the reactive metabolite syndrome, delineation of the risk factors for valproic acid toxicity, the potential role of carnitine in preventing valproic acid hepatotoxicity, and the toxicity of second-line antiepileptic drugs. Liver injury associated with newer psychotropic agents, particularly the selective serotonin reuptake inhibitors, is also discussed. The focus of the review is the hepatotoxicity of commonly used drugs with particular reference to recent and novel reports of toxicity. Well-known causes of liver injury such as chlorpromazine, phenytoin, and methyldopa are not discussed.

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Section: Aldosterone Receptor Antagonist (Spironolactone)mentioning

confidence: 99%

Hepatotoxicity of Commonly Used Drugs: Nonsteroidal Anti-Inflammatory Drugs, Antihypertensives, Antidiabetic Agents, Anticonvulsants, Lipid-Lowering Agents, Psychotropic Drugs

Chitturi¹,

George²

2002

Semin Liver Dis

194

106

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“…There is extensive experience with spironolactone, its safety and efficacy being well established. There has only been one other report of spironolactone possibly inducing hepatitis 5 . In that report, a 54‐year‐old woman with primary hyperaldosteronism was prescribed spironolactone 100 mg three times daily.…”

Section: Discussionmentioning

confidence: 99%

Spironolactone‐induced hepatitis

Thai

Sinclair

2001

Aust J Dermatology

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There is widespread use of spironolactone in medical practice and the indications for its use well established and side effect profile well known. Herein, we present a case of drug-induced hepatitis occurring in a 50-year-old woman using spironolactone for the treatment of androgenetic alopecia. Six weeks after commencement of spironolactone the patient became unwell, complained of an extensive itch, but no icterus or jaundice. Liver function tests found abnormally elevated bilirubin and enzymes levels. After withdrawal of spironolactone, the patient's symptoms resolved and liver function improved. To date, there has only been one other report of spironolactone-induced hepatitis.

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Spironolactone and Hepatic Toxicity

Renkes¹

1995

JAMA

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Spironolactone Hepatitis in Primary Hyperaldosteronism

Cited by 10 publications

References 3 publications

Hepatotoxicity of Commonly Used Drugs: Nonsteroidal Anti-Inflammatory Drugs, Antihypertensives, Antidiabetic Agents, Anticonvulsants, Lipid-Lowering Agents, Psychotropic Drugs

Hepatotoxicity of Commonly Used Drugs: Nonsteroidal Anti-Inflammatory Drugs, Antihypertensives, Antidiabetic Agents, Anticonvulsants, Lipid-Lowering Agents, Psychotropic Drugs

Spironolactone‐induced hepatitis

Spironolactone and Hepatic Toxicity

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