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European Journal of Clinical Pharmacology

, Volume 57, Issue 4, pp 321–326 | Cite as

Fatal hepatotoxicity secondary to nimesulide

  • Giorgio Merlani
  • Mark Fox
  • Hans-Peter Oehen
  • Gieri Cathomas
  • Eberhard L. Renner
  • Karin Fattinger
  • Markus Schneemann
  • Gerd A. Kullak-Ublick
Pharmacoepidemiology and Prescription

Abstract.

This report describes a 57-year-old female patient with chronic lumbago, who died from the sequelae of acute liver failure induced by nimesulide medication. Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) which preferentially inhibits cyclo-oxygenase 2 and has been associated with a total of 13 reported cases of severe liver injury including our case. On the basis of the literature reports, the following features of nimesulide-associated hepatotoxicity were identified: female sex (84% of cases), age (mean age 62 years), jaundice as a primary manifestation (90%) and the absence of peripheral blood eosinophilia. The average duration of therapy of the published cases was 62 days (range 7–180 days). Based on spontaneous reports to the World Health Organization, nimesulide induces a high proportion of severe adverse hepatic reactions compared with other NSAIDs registered in Switzerland. Hepatotoxicity thus represents an important risk factor of nimesulide usage.

Hepatitis Non-steroidal antiinflammatory drugs Adverse drug reaction 

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Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • Giorgio Merlani
    • 1
  • Mark Fox
    • 2
  • Hans-Peter Oehen
    • 3
  • Gieri Cathomas
    • 3
  • Eberhard L. Renner
    • 2
  • Karin Fattinger
    • 4
  • Markus Schneemann
    • 1
  • Gerd A. Kullak-Ublick
    • 2
  1. 1.Medizinische Klinik B, Department of Internal Medicine, University Hospital, 8091 Zurich, Switzerland
  2. 2.Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital, 8091 Zurich, Switzerland
  3. 3.Department of Pathology, University Hospital, 8091 Zurich, Switzerland
  4. 4.Division of Clinical Pharmacology and Toxicology, Department of Internal Medicine, University Hospital, CH-8091 Zurich, Switzerland

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