Phenytoin Toxicity After Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Bassell, Timothy; Aminlari, Amir; Hayden, Stephen R.; Rosso, Jake Del; Ly, Binh T.

doi:10.1016/j.jemermed.2020.09.010

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…10,11 Although TIPS placement restores portal venous flow in patients with cirrhosis, it further alters drug bioavailability through increased splanchnic blood flow and intrahepatic shunting. 12 Increased bioavailability and decreased clearance of drugs that have significant first-pass metabolisms such as bisoprolol, nifedipine, budesonide, midazolam, and phenytoin 1,3,4,6 have been demonstrated after TIPS. However, knowledge of the exact effects of TIPS on statin metabolism is not well understood.…”

Section: Discussionmentioning

confidence: 99%

“…1 Transjugular intrahepatic portosystemic shunt (TIPS), which is increasingly used to treat complications of cirrhosis, compounds this effect by further altering splanchnic hemodynamics. 2 Despite a number of reports describing toxicity of various drugs after TIPS placement, [1][2][3][4][5][6] clinicians may not intuitively recognize when potentially harmful medications should be doseadjusted after placement. We present the case of a patient who experienced statin-induced rhabdomyolysis likely as a direct result of TIPS placement.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Statin-Induced Rhabdomyolysis Associated With Transjugular Intrahepatic Portosystemic Shunt Placement

Swei¹,

Brar²,

Rice³

et al. 2022

ACG Case Rep J

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Rhabdomyolysis is a known rare and potentially lethal complication of statin use. This toxic effect is potentiated by alterations in hepatic physiology in patients with cirrhosis. Transjugular intrahepatic portosystemic shunt placement has the potential to further compound this effect; yet, examples of this have not previously been described in the literature. We present a case of a patient who experienced statin-induced rhabdomyolysis likely as a direct consequence of transjugular intrahepatic portosystemic shunt placement.

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