Acute liver injury related to the use of niperotidine.

Abstract

BACKGROUND/AIMS:

H2-receptor antagonists are widely used for the therapy of peptic disease, since they ensure a protracted and intense inhibition of gastric acidity. Niperotidine (piperonyl-ranitidine) is a new H2 blocking agent recently proposed for clinical use.

METHODS:

Twenty-five cases of acute hepatitis associated with the use of niperotidine were reported in Italy between March and August 1995. Intercurrent viral infections, recent drug and alcohol consumption and blood transfusions were excluded as causes.

RESULTS:

All patients showed an increase in the parameters of liver cell injury and the clinical symptoms of acute hepatitis. After withdrawal of the drug, all patients showed a good outcome, except one who developed a fulminant hepatitis and died from digestive tract bleeding.

CONCLUSIONS:

The absence of other causes of acute liver injury suggests that the observed liver injury may be a niperotidine-adverse reaction. Moreover, the lack of a relationship between the dose of the drug and the degree of liver damage, the variable latent period and the rarity and unpredictability of the injury are suggestive of an idiosyncratic reaction.

• Authors: G Gasbarrini, N Gentiloni, S Febbraro, A Gasbarrini, C Di Campli, M Cesana, F Miglio, M Miglioli, F Ghinelli, A D'Ambrosi, P Amoroso, F Pacini, G Salvadori
• Journal: Journal of hepatology (J Hepatol) Vol. 27 Issue 3 Pg. 583-6 (Sep 1997) ISSN: 0168-8278 [Print] Netherlands
• PMID: 9314138 (Publication Type: Journal Article)

Chemical References

• Dioxoles
• Furans
• Histamine H2 Antagonists
• niperotidine
• Aspartate Aminotransferases
• Alanine Transaminase
• Alkaline Phosphatase
• Bilirubin

Topics

• Acute Disease
• Adult
• Aged
• Aged, 80 and over
• Alanine Transaminase (metabolism)
• Alkaline Phosphatase (metabolism)
• Aspartate Aminotransferases (metabolism)
• Bilirubin (metabolism)
• Chemical and Drug Induced Liver Injury (etiology)
• Dioxoles (adverse effects)
• Female
• Furans (adverse effects)
• Histamine H2 Antagonists (adverse effects)
• Humans
• Male
• Middle Aged
• Retrospective Studies