Acute cholestasis following treatment with nimesulide and oral contraception - case report and review

Czech version

Authors: T. Koller ¹; A. Baňárová ¹; F. Ondriaš ²; J. Kollerová ¹; J. Payer ¹
Authors‘ workplace: V. interná klinika Lekárskej fakulty UK a FNsP Bratislava, Slovenská republika, prednosta prof. MUDr. Juraj Payer, CSc. ¹; Patológia Ružinov, Alpha medical patológia s. r. o., Bratislava, Slovenská republika, prednosta prim. doc. MUDr. František Ondriaš, CSc. ²
Published in: Vnitř Lék 2008; 54(6): 665-669
Category: Case Reports

Overview

Our case report of acute cholestatic liver injury highlights the potential hepatotoxicity of nimesulide treatment in combination with oral contraception. Rarely occuring histological findings of „pure“ cholestasis without any inflammatory or necrotic changes with favourable outcome following ursodeoxycholic acid administration are described. It was not possible to distinguish the separate role of any of these two drugs on hepatotoxicity according to the available information. Based on the known similarities in hepatotoxic profile of nimesulide and oral contraceptives, it can be assumed that their interaction could increase the risk of liver damage, although the precise mechanisms are not ellucidated yet. Nimesulide toxicity however is often reported in cases taking several potentially hepatotoxic drugs. It is therefore prudent to reconsider any concommitant treatment and closely monitor liver function tests in patients requiring nimesulide treatment.

Key words:
nimesulide - oral contraception - cholestasis - hepatotoxicity

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