Nimesulide-induced hepatotoxicity and fatal hepatic failure

Tan HH, Ong WMC, Lai SH, Chow WC
Correspondence: Dr Tan Hui-Hui, mhyhui@singnet.com.sg

ABSTRACT
Non-steroidal anti-inflammatory drugs (NSAIDs) and cyclo-oxygenase-2 (cox-2) inhibitors are structurally heterogeneous drugs that share similar therapeutic actions and adverse effects. Hepatotoxicity, although a relatively rare adverse effect of this class of drugs, can be severe. This has led to the withdrawal of some NSAIDs from the market. Nimesulide is an NSAID, with cox-2 preference, which has been reported to cause death from hepatic failure. However, most reports have been from European countries. Asian reports include that from Israel and India. We report three patients who presented with acute hepatitis after being prescribed nimesulide, one of whom died from fulminant hepatic failure.

Keywords: acute hepatitis , cyclo-oxygenase inhibitors, fulminant hepatic failure, hepatotoxicity, nimesulide-induced hepatotoxicity, non-steroidal anti-inflammatory drugs
Singapore Med J 2007; 48(6): 582-585