Document 0442
 DOCN  M9550442
 TI    Worsening of liver function with fluconazole and review of azole
       antifungal hepatotoxicity.
 DT    9505
 AU    Gearhart MO; Department of Pharmacy, Good Samaritan Hospital, Dayton,
       OH; 45406.
 SO    Ann Pharmacother. 1994 Oct;28(10):1177-81. Unique Identifier : AIDSLINE
       MED/95143711
 AB    OBJECTIVE: To report a case of fluconazole worsening of liver
       dysfunction. CASE SUMMARY: A patient with hepatitis experienced
       worsening of her liver function when treated with fluconazole for a
       Candida infection in her urine. Elevations in aspartate
       aminotransferase, alanine aminotransferase, and total bilirubin
       concentrations along with increased prothrombin time and activated
       partial thromboplastin time were noted as early as the second day of
       therapy. After discontinuation of the fluconazole, the liver parameters
       returned to their normal baseline level. DISCUSSION: Hepatotoxicity
       associated with azole antifungal therapy is reviewed. This patient
       experienced elevations in liver function enzymes; the literature
       relating to this topic is evaluated. CONCLUSIONS: It is probable that
       fluconazole therapy was involved in the worsening of this patient's
       liver function. Liver function should be monitored during the course of
       fluconazole therapy in patients with underlying liver dysfunction. It
       appears from the published reports that HIV-positive patients may be at
       risk for hepatotoxicity with fluconazole.
 DE    Administration, Oral  Alanine Aminotransferase/BLOOD  Aspartate
       Aminotransferase/BLOOD  Candidiasis/DRUG THERAPY  Case Report  Female
       Fluconazole/ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS  Hospitals,
       Teaching  Human  Liver Diseases/*CHEMICALLY INDUCED/ENZYMOLOGY  Liver
       Function Tests  Middle Age  Triazoles/*ADVERSE EFFECTS  Urinary Tract
       Infections/DRUG THERAPY  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

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