Severe hepatotoxicity associated with bromfenac sodium

Subacute hepatitis and liver failure occurred in a 40-yr-old woman followin g a 1-month course of treatment with the nonsteroidal anti-inflammatory dru g bromfenac. Serologies for hepatitis A, B, and C were negative, as were an tinuclear antibodies and ceruloplasmin. A transjugular liver biopsy demonst rated submassive hepatic necrosis. The clinical course was complicated by e ncephalopathy, fluid retention, and spontaneous bacterial peritonitis, prom pting consideration for liver transplantation. With supportive measures, ja undice and fluid retention resolved over a 3-month period. We conclude that prolonged use of bromfenac was the etiological agent in this case, and tha t this drug can cause severe hepatotoxicity resulting in liver failure. (C) 1999 by Am. Cell. of Gastroenterology.