Losartan-induced ischemic hepatocellular hepatotoxicity: A case report and literature review

Al-Halawani, Moh’d; Thawabi, Mohammad; Asslo, Fady; Shaaban, Hamid; Shamoon, Fayez; Baddoura, Walid

doi:10.4103/2249-4863.141635

Cited by 11 publications

(7 citation statements)

References 12 publications

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“…In 1995, the Food and Drug Administration (FDA) approved losartan for the treatment of arterial hypertension [1]. It was also approved for reducing risks of cerebrovascular accidents in patients with hypertension or left ventricular hypertrophy, and for slowing the progression of diabetic nephropathy by improving proteinuria [1]. Losartan has been studied extensively for the management of the aforementioned conditions.…”

Section: Discussionmentioning

confidence: 99%

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Losartan-induced Severe Hepatic Injury: A Case Report and Literature Review

Patti

Sinha

Sharma

et al. 2019

Cureus

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Medications have been known to cause adverse drug reactions that affect various organs; these are mostly reversible reactions that improve with the cessation of the culprit medication. Losartan is an angiotensin-one receptor blocker which has been approved by the Food and Drug Administration (FDA) for the treatment of arterial hypertension. Fatigue, anemia, weakness, and cough are some of the common adverse effects of losartan. Acute hepatic injury has rarely been reported as an adverse effect of losartan. We report a case of a 61-year-old female with severe hepatic injury secondary to losartan use. None of the cases reported so far had such a high elevation of liver enzymes as seen in our patient.

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Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, 18 cases of angiotensin receptor blocker causing liver injury has been reported. Out of those, six cases were due to losartan, five were with Irbesartan, four with candesartan, and three cases were due to valsartan use as listed in Table 3 [1,5-10].…”

Section: Discussionmentioning

confidence: 99%

Losartan-induced Severe Hepatic Injury: A Case Report and Literature Review

Patti

Sinha

Sharma

et al. 2019

Cureus

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“…Some drugs are well known to cause acute liver injury, especially following an overdose. Losartan is a well-tolerated drug with few significant adverse effects, the most common of which are dry cough, hyperkalaemia and gastrointestinal effects [ 2 ] . Although uncommon, a transient elevation in hepatic transaminases can occur in <2% of patients.…”

Section: Introductionmentioning

confidence: 99%

Drug-Induced Liver Injury Due To Losartan

Diogo

Monteiro

Coelho

et al. 2021

European Journal of Case Reports in Internal Medicine

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Drug-induced liver injury (DILI) is a challenging diagnosis since a wide variety of medicines can cause adverse reactions. Losartan is an angiotensin II receptor antagonist (ARA-II) approved for the treatment of arterial hypertension. The most common adverse effects are fatigue, anaemia, weakness and cough. An increase in transaminases has been reported with less frequency (<2% of cases). Although the mechanism is not fully understood, DILI onset is usually within 1–8 weeks of therapy, and hepatic enzymology usually normalizes 2–4 months after drug suspension. The authors present the case of a 66-year-old male patient with a medical history of arterial hypertension and a prior hospitalization (4 years previously) for drug-induced hepatitis, which, at the time, was attributed to a dietary supplement. Four years later, because of new onset of hypertension, losartan was reintroduced. After 3 weeks, the patient was admitted to the emergency department with complaints of acute abdominal pain associated with asthenia, nausea and increased abdominal volume that had first developed 8 days previously. After exclusion of other causes, DILI associated with losartan was assumed. This is a very rare adverse effect since only seven cases have been described in the literature.

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“…[ 1 ] The first ARB used was losartan, and several reports have evaluated losartan-induced hepatotoxicity, although it is rare (<0.1%). [ 2 – 4 ] Furthermore, there have been several other reports on irbesartan-, candesartan-, and valsartan-induced hepatotoxicity, which is far less common than losartan-induced hepatotoxicity. [ 4 – 8 ] To our knowledge, there is no published report yet on liver injury caused by fimasartan.…”

Section: Introductionmentioning

confidence: 99%

“…[ 2 – 4 ] Furthermore, there have been several other reports on irbesartan-, candesartan-, and valsartan-induced hepatotoxicity, which is far less common than losartan-induced hepatotoxicity. [ 4 – 8 ] To our knowledge, there is no published report yet on liver injury caused by fimasartan. We report a case of hepatotoxicity caused by fimasartan.…”

Section: Introductionmentioning

confidence: 99%

Fimasartan-induced liver injury in a patient with no adverse reactions on other types of angiotensin II receptor blockers

Park¹,

Yun²,

Eun³

et al. 2017

Medicine

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Rationale:Angiotensin II receptor blockers (ARBs) are widely used for patients with hypertension, and fimasartan is a recently approved ARBs. Fimasartan can cause headache, dizziness, itching, and coughing. There have been several reports of hepatotoxicity in ARBs. However, there have not yet been published reports of the hepatotoxicity of fimasartan.Patient concerns:A 73-year-old man with hypertension experienced liver injury after fimasartan administration. He had a previous history of taking 3 types of ARBs each for more than 2 years before taking fimasartan, and there were no side effects on ARBs except for fimasartan.Diagnoses:Other factors that could cause liver injury were excluded in diagnostic tests, and fimasartan was suspected to be the causative agent.Intervention:Fimasartan was immediately discontinued and the patient was managed with supportive care via hepatotonics.Diagnoses:Other factors that could cause liver injury were excluded in diagnostic tests, and fimasartan was suspected to be the causative agent.Outcome:The liver injury due to fimasartan was confirmed by histology and accidental redosing.Lessons:We emphasize that liver function should be monitored during fimasartan administration because fimasartan may cause hepatotoxicity in patients who have no side effects with other types of ARBs. And fimasartan-induced liver injury may appear later than other ARBs.

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Losartan-induced ischemic hepatocellular hepatotoxicity: A case report and literature review

Cited by 11 publications

References 12 publications

Losartan-induced Severe Hepatic Injury: A Case Report and Literature Review

Losartan-induced Severe Hepatic Injury: A Case Report and Literature Review

Drug-Induced Liver Injury Due To Losartan

Fimasartan-induced liver injury in a patient with no adverse reactions on other types of angiotensin II receptor blockers

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