Felbamate‐associated fatal acute hepatic necrosis

  title={Felbamate‐associated fatal acute hepatic necrosis},
  author={Michael G O'neil and C S Perdun and M. B. Wilson and S T McGown and S P Patel},
  pages={1457 - 1457}
Thirty-six cases of hepatic toxicity associated with felbamate therapy have been collected by the Food and Drug Administration. Five patients died. We describe a case of massive acute hepatic necrosis and death within 40 days of initiation of felbamate therapy for a generalized tonic-clonic seizure disorder. We describe the clinical and histopathologic features. 
Hepatotoxicity associated with antiepileptic drugs
This work has shown that liver injury associated with antiepileptic drugs (AED) is well recognized but the consequences can be very serious leading to death or liver transplantation due to acute liver failure induced by these drugs. Expand
Chapter 24 – Anticonvulsant Agents
Prisposition to liver injury may be genetically mediated but clinical risk factors have also been identified, which need to be taken into account when deciding which anticonvulsant to choose for a patient. Expand
Drugs and Toxins
This chapter reviews the patterns of injury observed in toxic injury as well as what is known about injury due to particular substances. Expand
Felbamate in Epilepsy Therapy
With monitoring, patient education, and continued research to further elucidate risk factors, felbamate can be a viable therapeutic agent for patients with epilepsy. Expand
Drug-induced liver injury
Although no pharmacological therapy has been adequately tested in randomized clinical trials, corticosteroids can be useful, particularly in the emergent form of DILI related to immune-checkpoint inhibitors in patients with cancer. Expand
Felbamate in intractable pediatric and young adult epilepsy
FBM seemed to be effective in reducing seizure frequency and should be considered a viable current option for treatment of intractable seizures in children, though weight should be monitored in these patients. Expand
Mechanisms of idiosyncratic drug reactions: the case of felbamate.
The data suggest that under normal physiological conditions glutathione plays a protective role in preventing IDR during felbamate therapy, further emphasizing a correlation between reactive metabolite formation and a toxic outcome. Expand
Antiepileptic drug treatment in the nineties in The Netherlands.
In this review the ‘state of the art’ of treating patients with epilepsy in the nineties in the Netherlands is presented. It describes general strategies for treatment with antiepileptic drugs andExpand
Felbamate: Therapeutic range and other kinetic information
A retrospective study was performed to identify the therapeutic range and pharmacokinetic parameters of felbamate (FBM). Data from 104 patients visits were analyzed. FBM was the sole agent in 40%.Expand
Drug induced liver disease
Drug-induced liver disease can result from dosage-dependent hepatotoxicity or from adverse reactions to drugs used in therapeutic dosage, so that drugs must be considered as the possible causal agent for all unexplained cases of liver disease. Expand


Hepatic injury associated with diphenylhydantoin therapy. A clinicopathologic study of 20 cases.
Clinically, 75% of the patients had fever, 62.5% had rash, and 89% had eosinophilla, and most patients recovered after the drug was discontinued, and the interval between the beginning of therapy and the adverse drug reaction varied from one to eight weeks. Expand
Hepatic reactions to nifedipine
Evidence suggests that the toxic effect of nifedipine on the liver is due to hypersensitivity, and two cases in which abnormal liver function tests were associated with the use of the drug are reported. Expand
Aplastic Anemia in a Patient Receiving Felbamate for Complex Partial Seizures
The association between fel bamate and aplastic anemia has resulted in a joint recommendation by the US Food and Drug Administration and the manufacturer of felbamate, Carter-Wallace, Inc., for the immediate withdrawal of patients from treatment with felbamine. Expand
Metoprolol-induced hepatitis: rechallenge and drug oxidation phenotyping.
Excerpt Metoprolol is a widely used beta-adrenoreceptor antagonist. To our knowledge, there is no report of hepatitis involving this drug as well as other beta-adrenoreceptor antagonists (1). Metop...
Histopathology of the Liver
  • P. Beeson
  • The Yale Journal of Biology and Medicine
  • 1994
for the pathophysiology of heart failure assumes that the readers are already fam liar with the mechanisms involved. Thus, this volume may not be useful for most medical students. Finally, for aExpand
Nuclear magnetic resonance becomes established
It is clear that the demonstrated value of MRI is such that government agencies should now be contemplating the funding of units in the public hospital system, and planning for the salary and staffing needs of such units should anticipate a research role for MRI, which is likely to be considerably greater than that of CT. Expand
Fulminant hepatic failure. Presumable contribution to halothane.