Reactions 1324 - 23 Oct 2010

★ SRopinirole

Liver injury (first report) in an elderly patient:case report

A 68-year-old woman, who had been receiving thyroidhormone therapy for hypothyroidism, commencedtreatment with ropinirole 0.25mg, 3 times daily [route notstated], for restless legs syndrome. She was admitted to anemergency department 3 months later with nausea,jaundice, asthenia, choluria and acholic stools. Laboratorytest results included the following values: ALT 2 399 U/L,AST 1 242 U/L, alkaline phosphatase 2 020 U/L, LDH516 U/L, total bilirubin 11.1 mg/dL (conjugated fraction7.6 mg/dL) and ferritin 4 131 ng/mL. Tests for a viral orautoimmune source of liver toxicity were negative.Ropinirole was discontinued and her clinical symptomsimproved, with normalisation of liver enzymes after2 months. Ropinirole treatment was successfully replacedwith gabapentin.

Author comment: "The exclusion of other possible causesof hepatitis and the temporal relationship with the use ofropinirole suggests that liver toxicity was possibly induced bythis drug."Navacerrada F, et al. Liver toxicity possibly related with ropinirole use. 14thCongress of the European Federation of Neurological Societies : abstr. P2093, 25Sep 2010. Available from: URL: http://www.efns.org/efns2010 -Spain 803042543

» Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports of liverinjury associated with ropinirole. The WHO ADR databasecontained one report of liver injury associated withropinirole.

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Reactions 23 Oct 2010 No. 13240114-9954/10/1324-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved