Flutamide-Related Fulminant Hepatic Failure

Corkery, Joseph; Bihrle, William; McCaffrey, Joyce A.; Whitcomb, Frederick F.; Levy, Carol J.; Ellis, Ronald D.

doi:10.1097/00004836-199106000-00025

Cited by 15 publications

(1 citation statement)

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“…Flutamide has been described as a potent hepatotoxin in certain patients [56] and clinical hepatotoxicity is well-documented in clinical trial reports [11,23,24,42,48], individual case reports, and series of case reports [56][57][58][59][60][61][62][63][64][65]. Flutamide has a short half-life (six to eight hours for the active metabolite 2-hydroxyflutamide).…”

Section: Occurrence Of Diarrhea In a Double-blind Comparison Of Flumentioning

confidence: 99%

Tolerability of Nonsteroidal Antiandrogens in the Treatment of Advanced Prostate Cancer

McLeod

1997

The Oncologist

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This review compares the tolerability profiles of the three currently available nonsteroidal antiandrogens, flutamide, bicalutamide and nilutamide. Pharmacological effects associated with blockade of the androgen receptor are frequent with all three drugs. Gynecomastia and breast pain are seen more frequently during antiandrogen monotherapy than during combination with medical or surgical castration or castration alone, and the reverse is true for hot flashes, which are a side effect of castration. Gastrointestinal symptoms are also common to all three drugs, but diarrhea occurs more frequently in flutamide studies than in bicalutamide or nilutamide studies. Hepatotoxicity has been seen with all three antiandrogens, but acute, reversible hepatitis and fatal fulminant hepatitis have also been reported with both nilutamide and flutamide. All three drugs have been associated with asymptomatic elevations in aminotransferases and may reduce hemoglobin levels. Adverse events that have been reported with nilutamide include interstitial pneumonitis, delayed adaptation to darkness after exposure to bright light and alcohol intolerance. To date, bicalutamide appears to have some advantage over flutamide and nilutamide in terms of tolerability.

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Section: Occurrence Of Diarrhea In a Double-blind Comparison Of Flumentioning

confidence: 99%

Tolerability of Nonsteroidal Antiandrogens in the Treatment of Advanced Prostate Cancer

McLeod

1997

The Oncologist

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Cholestatic hepatitis following flutamide

et al. 1993

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Flutamide-induced toxic hepatitis

et al. 1996

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Flutamide is a nonsteroidal antiandrogen commonly used in the treatment of prostate cancer. Hepatic toxicity associated with flutamide has been reported with an incidence from less than 1% to about 5%. Ursodeoxycholic acid (UDCA), a hydrophilic bile acid, has been widely used in the treatment of cholesterol gallstones and of several liver diseases, but few data are now available concerning its use in the management of drug-induced hepatitis. The case of a patient who presented severe hepatitis with jaundice following use of flutamide is reported. UDCA treatment was started on admission and, contemporaneously, flutamide was withdrawn. Clinical and biochemical improvement was progressively observed, and the patient was discharged six weeks after the admission. Since fatal flutamide-related hepatitis has been reported, monitoring of serum liver tests is advocated during flutamide administration, and the effectiveness of UDCA in the treatment of drug-induced hepatotoxicity requires further study.

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Flutamide-Related Fulminant Hepatic Failure

Cited by 15 publications

References 0 publications

Tolerability of Nonsteroidal Antiandrogens in the Treatment of Advanced Prostate Cancer

Tolerability of Nonsteroidal Antiandrogens in the Treatment of Advanced Prostate Cancer

Cholestatic hepatitis following flutamide

Flutamide-induced toxic hepatitis

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