Drug-induced hepatitis in a patient with malignant melanoma treated with interferon alfa 2b adjuvantly who had been administered gemfibrozil in therapy.
A well-known side effect of chemotherapy, covering a wide range of drugs, is drug-induced hepatitis. We are reporting on a 61-yr-old female patient whose malignant melanoma had been surgically removed, and on whom adjuvant therapy with interferon alfa 2b was initiated. The patient had mild hyperlipidemia, of which she had been aware for several years, but which had gone untreated with medicinal intervention. After the patient was started on interferon alfa therapy, continuously increasing values of triglyceride were measured. Therefore, 3 mo after the introduction of adjuvant therapy, gemfibrozil was prescribed at a dose of 600 mg per day. Within a few days after the patient had been taking this combined therapy, the clinical and laboratory values of drug-induced hepatitis developed. Soon after discontinuance of treatment by both drugs, the signs and symptoms of hepatitis disappeared. Adjuvant interferon therapy was not continued afterward owing to the patient's wish. We do not know if the hepatitis was the side effect to gemfibrozil alone, or the side effect was a result of an interaction between the two drugs. As far as we could find, this is the first case report of possible negative interaction between interferon alfa 2b and gemfibrozil. Our intention in this article is to point out that prescription of any drugs, especially new ones, should be balanced and carefully monitored because of possible side effects.
Grubisić-Cabo
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Center of Oncology, Clinical Hospital, Split, Croatia. fgrubisic@yahoo.com
Vrdoljak
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D000970:Antineoplastic Agents / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D004347:Drug Interactions; D005260:Female; D015248:Gemfibrozil / Q000009:adverse effects*; D006801:Humans; D000960:Hypolipidemic Agents / Q000009:adverse effects*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D008545:Melanoma / Q000188:drug therapy*; D008875:Middle Aged; D011994:Recombinant Proteins
D000970:Antineoplastic Agents; D000960:Hypolipidemic Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D015248:Gemfibrozil