Koller T, Banárová A, Ondrias F, Kollerová J, Payer J
V. interná klinika Lekárskej fakulty UK a FNsP Bratislava, Slovenská republika.
Vnitr Lek. 2008 Jun;54(6):665-9.
Our case report of acute cholestatic liver injury highlights the potential hepatotoxicity of nimesulide treatment in combination with oral contraception. Rarely occuring histological findings of "pure" cholestasis without any inflammatory or necrotic changes with favourable outcome following ursodeoxycholic acid administration are described. It was not possible to distinguish the separate role of any of these two drugs on hepatotoxicity according to the available information. Based on the known similarities in hepatotoxic profile of nimesulide and oral contraceptives, it can be assumed that their interaction could increase the risk of liver damage, although the precise mechanisms are not ellucidated yet. Nimesulide toxicity however is often reported in cases taking several potentially hepatotoxic drugs. It is therefore prudent to reconsider any concommitant treatment and closely monitor liver function tests in patients requiring nimesulide treatment.
我们关于急性胆汁淤积性肝损伤的病例报告强调了尼美舒利与口服避孕药联合使用时潜在的肝毒性。文中描述了罕见的“单纯”胆汁淤积组织学表现，无任何炎症或坏死改变，给予熊去氧胆酸后预后良好。根据现有信息，无法区分这两种药物中任何一种对肝毒性的单独作用。基于尼美舒利和口服避孕药在肝毒性方面已知的相似性，可以推测它们的相互作用可能会增加肝损伤风险，尽管确切机制尚未阐明。然而，尼美舒利毒性在服用几种潜在肝毒性药物的病例中经常有报道。因此，对于需要使用尼美舒利治疗的患者，谨慎的做法是重新考虑任何联合治疗，并密切监测肝功能检查。
