title: Suspected cross-reactivity of enalapril- and captopril-induced hepatotoxicity.
abstract: OBJECTIVE
  To present evidence that enalapril and captopril may produce hepatotoxicity by a common mechanism.
  
  
  METHODS
  A case report and review of pertinent literature.
  
  
  RESULTS
  A patient developed hepatotoxicity once while taking enalapril and again while taking captopril. Hepatotoxicity resolved with cessation of therapy. Hepatotoxicity has been reported with use of captopril, enalapril, and lisinopril. Apparent cross-reactivity has been reported on just one other occasion.
  
  
  CONCLUSIONS
  Because hepatotoxicity is uncommon with angiotensin-converting enzyme (ACE) inhibitors, our observations suggest the possibility that these agents produce hepatotoxicity by a common mechanism. In patients who develop hepatotoxicity while taking one ACE inhibitor, other agents in this class probably should be avoided.
authors.affiliation: Department of Medicine, Akron City Hospital, OH 44309.
authors.forename: M T
authors.initials: MT
authors.lastname: Hagley
authors.forename: R L
authors.initials: RL
authors.lastname: Benak
authors.forename: D T
authors.initials: DT
authors.lastname: Hulisz
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002216:Captopril / Q000009:adverse effects* / Q000737:chemistry; D056486:Chemical and Drug Induced Liver Injury; D004656:Enalapril / Q000009:adverse effects* / Q000737:chemistry; D006801:Humans; D008107:Liver Diseases / Q000201:enzymology; D008297:Male; D008875:Middle Aged
chemical_list: D004656:Enalapril; D002216:Captopril; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase