| Ondansetron-induced aminotransferase level elevation: case report and review of the literature. | |
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MedLine Citation:
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PMID: 19025436 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Elevation of aminotransferase levels is a rarely reported adverse effect of ondansetron. Increased aminotransferase levels, however, have been observed in patients receiving concurrent cisplatin chemotherapy and ondansetron. We describe a 44-year-old woman with no oncologic history or treatment with chemotherapy who received intravenous ondansetron on three separate occasions in the emergency department and subsequently experienced aminotransferase level abnormalities. Her baseline aspartate aminotransferase levels were within normal limits on each occasion, but increased to several times the upper limit of normal within 1 day of admission. After a diagnostic evaluation and drug review were performed, ondansetron appeared to be the most likely cause. On discontinuation of ondansetron, her aminotransferase levels trended downward, and the patient was discharged in stable condition. The Naranjo adverse drug reaction probability scale score for this event was 9, indicating that ondansetron was a definite cause of the elevated aminotransferase levels. Some studies describe a higher rate of increased aminotransferase levels in patients with cancer who are treated with ondansetron compared with those receiving metoclopramide. These elevations are not dose related and have not been associated with liver injury. Furthermore, the chemotherapeutic agent administered may play a role in aminotransferase level elevations. Since cisplatin was administered in most of these studies and is known to independently cause hepatotoxicity, the overall contribution of ondansetron to aminotransferase level elevation is not fully known. With the increased use of ondansetron outside of oncologic medicine, it is important that clinicians are aware of this rare adverse effect when determining the cause of elevated aminotransferase levels. |
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Authors:
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Michael J Lewandowski; Scott A Chapman |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Pharmacotherapy Volume: 28 ISSN: 0277-0008 ISO Abbreviation: Pharmacotherapy Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-11-25 Completed Date: 2009-02-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8111305 Medline TA: Pharmacotherapy Country: United States |
Other Details:
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Languages: eng Pagination: 1542-6 Citation Subset: IM |
Affiliation:
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Department of Pharmacy Services, North Memorial Medical Center, Robbinsdale, MN, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Alanine Transaminase / metabolism* Aspartate Aminotransferases / metabolism* Coronary Artery Disease / drug therapy Female Humans Injections, Intravenous Ondansetron / administration & dosage, adverse effects*, therapeutic use Serotonin Antagonists / administration & dosage, adverse effects, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Serotonin Antagonists; 99614-02-5/Ondansetron; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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