• PDF / 173,789 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 35 Downloads / 159 Views

DOWNLOAD

REPORT

---

1 S

Drug induced liver injury and off label use: 5 case reports In a study, 5 men aged between 26–75 years were described, who were admitted to the ICU in Italy during March 2020 and April 2020, who developed drug-induced liver injury during off-label treatment with remdesivir and lopinavir/ritonavir for Covid-19 [not all dosages, routes, time to reaction onsets and outcomes stated]. This report describes a 75-year-old man (patient 1): The man, who was admitted to ICU due to COVID-19, started receiving offlabel treatment with oral lopinavir/ritonavir 400/100mg twice daily and oral hydroxychloroquine 200mg twice daily. However, his bilirubin level elevated due to lopinavir/ritonavir administration. Thereafter, he scheduled to receive off-label IV remdesivir 200mg as loading dose, followed by 100mg daily over 1 hour for up to 9 days. Subsequently, his bilirubin level reduced; however, his AST/ ALT significantly elevated by day 3 of remdesivir therapy. He was then diagnosed with liver injury secondary to remdesivir and lopinavir/ritonavir. On day 5, he showed torsade de pointes [aetiology not stated], which required cardiac resuscitation. Remdesivir was discontinued. Subsequently, his drug induced liver injury improved. This report describes a 26-year-old man (patient 2): The man, who was admitted to ICU due to COVID-19, started receiving offlabel treatment with oral lopinavir/ritonavir 400/100mg twice daily, oral hydroxychloroquine 200mg twice daily, cobicistat/ darunavir and avibactam/ceftazidime plus daptomycin. However, his bilirubin level elevated due to lopinavir/ritonavir administration. Thereafter, he scheduled to receive off-label IV remdesivir 200mg as loading dose, followed by 100mg daily over 1 hour for up to 9 days. Subsequently, his bilirubin level reduced; however, his AST/ALT significantly elevated by day 3 of remdesivir therapy. He was then diagnosed with drug induced liver injury secondary to remdesivir and lopinavir/ritonavir. Subsequently, his drug induced liver injury improved. This report describes a 56-year-old man (patient 3): The man, who was admitted to ICU due to COVID-19, started receiving offlabel treatment with oral lopinavir/ritonavir 400/100mg twice daily, oral hydroxychloroquine 200mg twice daily, meropenem and linezolid. However, his bilirubin level elevated due to lopinavir/ritonavir administration. Thereafter, he scheduled to receive off-label IV remdesivir 200mg as loading dose, followed by 100mg daily over 1 hour for up to 9 days. Subsequently, his bilirubin level reduced; however, his AST/ALT significantly elevated by day 3 of remdesivir therapy. He was then diagnosed with drug induced liver injury secondary to remdesivir and lopinavir/ritonavir. On day 5 of remdesivir therapy, he died due to unknown cause. This report describes a 51-year-old man (patient 4): The man, who was admitted to ICU due to COVID-19, started receiving offlabel treatment with oral lopinavir/ritonavir 400/100mg twice daily, oral hydroxychloroquine 200mg twice daily, cobicistat/ darunavir and avibactam/ceft