[Acute hepatitis due to ticlopidine. A report of 12 cases and review of the literature].
OBJECTIVE
To analyze the characteristics of hepatotoxicity due to ticlopidine.


METHODS
We describe all the case of hepatotoxicity attributed to ticlopidine and reported to the Register of drug associated hepatopathies. We also obtained data from MEDLINE and the Spanish Medical Index regarding cases reported during the period 1982 2001.


RESULTS
We reported twelve cases of hepatopathy related to the use of ticlopidine. These made up 5% of all the cases notified to the Register. Eighty three percent of the patients were male, and of an average age of 68 years. Sixty six percent required hospital admission. The latent period varied between 2 and 13 weeks. The liver lesion was of cholestatic type in 75% of the cases, hepatocellular in 16.6% and mixed in 8.3%. Twenty five percent of the patients had received sub therapeutic doses.


CONCLUSIONS
Ticlopidine is often related to hepatotoxicity. This seems to be due to an idiosyncratic mechanism and is mainly cholestatic. The use of lower dosage than that recommended means that the desired therapeutic effect is not attained but does not protect against the development of hepatotoxicity. Doctors who use this drug should be aware of this so as to establish the true risk benefit relation.
Pizarro
A E
AE
Unidad de Hepatología y Servicio de Farmacología Clínica; Universidad de Málaga. Facultad de Medicina, Málaga, 29071, España, Italy.
Andrade
R J
RJ
García-Cortés
M
M
Lucena
M I
MI
Pérez-Moreno
J M
JM
Puertas
M
M
Sánchez-Martínez
H
H
Montero
J L
JL
Durán
J A
JA
Jiménez
M
M
Ruiz-Montero
A
A
Soto-Conesa
M J
MJ
Rodrigo
L
L
de Francisco
R
R
Alcántara
R
R
Camargo
R
R
D000368:Aged; D000369:Aged, 80 and over; D001774:Blood Chemical Analysis; D056486:Chemical and Drug Induced Liver Injury / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D013988:Ticlopidine / Q000009:adverse effects*
D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine
Hepatitis aguda por ticlopidina. Presentación de 12 casos y revisión de la literatura.