Tropical Journal of Pharmaceutical Research

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Case Report

Cholestatic Hepatitis Secondary to Carbamazepine Treatment with Ursodeoxycholic Acid - A Case Report

Noor H Sabariah¹, Maisharah SG Siti¹, Aizal CH Nor² and Amer Hayat Khan¹

¹Department of Clinical Pharmacy, School of Pharmaceutical Sciences, ²School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia

*For correspondence: Email: sabariahnoor@yahoo.com; Tel: + 6097671186, + 60174515184; Fax: + 6097671199

Received: 8 Decemebr 2013 Revised accepted: 29 August 2014

Tropical Journal of Pharmaceutical Research, October 2014; 13(10): 1745-1747

http://dx.doi.org/10.4314/tjpr.v13i10.26

Abstract

Background: Drug-induced hepatitis and several features of liver toxicity associated with the administration of carbamazepine have been reported; they involve non-immunoallergic hepatotoxicity and immunoallergic hypersensitivity syndrome. Ursodeoxycholic acid (UDCA) has liver protective effects and is indicated for hepatitis.

Case: An 18-year old patient with epilepsy and on carbamazepine 200 mg once daily was admitted to a hospital for generalised rash and significant elevation of liver enzymes. Carbamazepine was discontinued and replaced with leviteracetam 250 mg twice daily. Patient had cholestatic features of liver damage and UDCA 500 mg twice daily was given for 2 weeks until liver enzymes normalized.

Conclusion: Ursodeoxycholic acid treatment could be an alternative treatment for patient with carbamazepine-induced hepatitis.

Keywords: Carbamazepine, Drug-induced hepatitis, Liver damage Ursodeoxycholic acid, Leviteracetam