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| ADR REPORT |
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| Year : 2009 | Volume
: 55
| Issue : 2 | Page : 141-142 |
Montelukast induced acute hepatocellular liver injury
A Harugeri1, G Parthasarathi1, J Sharma2, GA D'Souza3, M Ramesh1
1 Department of Pharmacy Practice, JSS College of Pharmacy, Mysore, India
2 Department of Pharmacology, St. John's Medical College Hospital, Bangalore, India
3 Division of Chest Medicine, Department of Medicine, St. John's Medical College Hospital, Bangalore, India
Correspondence Address:
G Parthasarathi
Department of Pharmacy Practice, JSS College of Pharmacy, Mysore
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0022-3859.52850
A 46-year-old male with uncontrolled asthma on inhaled albuterol and formoterol with budesonide was commenced on montelukast. He developed abdominal pain and jaundice 48 days after initiating montelukast therapy. His liver tests showed an increase in serum total bilirubin, conjugated bilirubin, aspartate aminotranferase, alanine aminotranferase, and alkaline phosphatase. The patient was evaluated for possible non-drug related liver injury. Montelukast was discontinued suspecting montelukast induced hepatocellular liver injury. Liver tests began to improve and returned to normal 55 days after drug cessation. Causality of this adverse drug reaction by the Council for International Organizations of Medical Sciences or Roussel Uclaf Causality Assessment Method (CIOMS or RUCAM) and Naranjo's algorithm was 'probable'. Liver tests should be monitored in patients receiving montelukast and any early signs of liver injury should be investigated with a high index of suspicion for drug induced liver injury.
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