[Severe electrolyte imbalance and edema in therapy with rosiglitazone].
METHODS
A case of a 49-year-old male with preexisting liver damage is reported. The patient was admitted to hospital with severe electrolyte disorder and face edema after therapy first with 4 mg for 2 months and later for 5 months with 8 mg rosiglitazone. The initial electrolyte values were: sodium 110 mmol/l, potassium 3.3 mmol/l, calcium 2.0 mmol/l, chloride 81 mmol/l. An already known hypercholesterolemia worsened substantially to values up to 28.5 mmol/l. Under substitution therapy with sodium chloride infusion and potassium, the electrolyte level normalized rapidly. The hypercholesterolemia improved over several weeks after stopping the drug, and the general condition of the patient improved clearly.


CONCLUSIONS
Rosiglitazone has been certified in Germany since July 2000. Although a liver toxicity with rosiglitazone has been denied, the administration of this drug in patients with liver damage is contraindicated. Especially when prescribing new drugs one has to pay special attention to contraindications and comedication since often not all therapeutic mechanisms and side effects are fully known/understood. Interaction between different drugs and their influences on existing diseases are only noticed after a widespread application of the drug.
Kuschel
Ursula
U
Institut für Klinische Pharmakologie, Klinikum der Friedrich-Schiller-Universität Jena.
Hesselbarth
Norbert
N
Herrmann
Andreas
A
Hippius
Marion
M
Hoffmann
Annemarie
A
D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology; D000075202:Contraindications; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004487:Edema / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008108:Liver Diseases, Alcoholic / Q000150:complications / Q000175:diagnosis; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D000077154:Rosiglitazone; D013844:Thiazoles / Q000009:adverse effects* / Q000627:therapeutic use; D045162:Thiazolidinediones; D014883:Water-Electrolyte Imbalance / Q000139:chemically induced* / Q000175:diagnosis
D007004:Hypoglycemic Agents; D013844:Thiazoles; D045162:Thiazolidinediones; D000077154:Rosiglitazone