Ranitidine and Hepatotoxicity
Authors: DAVID Y. GRAHAM
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 March 1985Ranitidine and HepatotoxicityDAVID Y. GRAHAM, M.D., ANTONE R. OPEKUN, P.A., J. LACEY SMITH, M.D., JIM T. SCHWARTZ, M.D.DAVID Y. GRAHAM, M.D.Search for more papers by this author, ANTONE R. OPEKUN, P.A.Search for more papers by this author, J. LACEY SMITH, M.D.Search for more papers by this author, JIM T. SCHWARTZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-3-416_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Two articles in the August issue reported liver injury possibly associated with the use of ranitidine. Lima (1) reported a well-documented case of ranitidine hepatitis, proved by challenge. In an adjacent paper, Black and associates (2) reported the cases of three symptomatic patients with fever and liver biochemical abnormalities occurring coincident with ranitidine use and suggested that the clinical picture was due to ranitidine. We take exception that the second paper was published, particularly "back to back," which added credence to it. We report a case of non-ranitidine-associated hepatitis to show problems in deciding whether liver abnormalities...References1. LIMA J. Hepatitis associated with ranitidine. Ann Intern Med. 1984;101:207-8. LinkGoogle Scholar2. BLACK M, SCOTT W, and KANTER R. Possible ranitidine hepatotoxicity. Ann Intern Med. 1984;101:208-9. LinkGoogle Scholar3. DAVIDSON C, LEEVY C, and CHAMBERLAYNE E. Guidelines for Detection of Hepatotoxicity Due to Drugs and Chemicals. Bethesda, Maryland: National Institutes of Health; 1979. (NIH publication no. 79-313.) Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DAVID Y. GRAHAM, M.D.; ANTONE R. OPEKUN, P.A.; J. LACEY SMITH, M.D.; JIM T. SCHWARTZ, M.D.Affiliations: Veterans Administration Medical Center Baylor College of Medicine Houston, TX 77211▸We agree with Dr. Graham and associates on the prompt reporting of suspected adverse effects to manufacturers and the Food and Drug Administration (FDA) (as stated in the editorial note in the February issue—Abrutyn E. Better reporting of adverse drug reactions. Ann Intern Med. 1985;102:264-5). But we also believe journals have some obligation at times to report cases with some uncertainty of causal association if the uncertainties are made clear, if the toxicity may be a serious problem, and if alternative treatment is available. That seems to us a policy with a stronger ethical basis with regard to patients' interests than a policy that may conceal adverse effects from the profession until all doubt of causal association has been dispelled. Raising questions in journals of adverse effects may have the additional virtue of eliciting more reports to the FDA, if not to the journal.—The Editor. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byImmunopathology of the Hepatobiliary SystemNephrotoxicity and Hepatotoxicity of Histamine H2 Receptor AntagonistsPossible Cholestatic Injury From Ranitidine With a Review of the LiteratureHEPATOTOXICITY OF DRUGS USED IN THE TREATMENT OF GASTROINTESTINAL DISORDERSAdverse Reactions and Interactions with H2-Receptor Antagonists 1 March 1985Volume 102, Issue 3Page: 416-416KeywordsAdverse reactionsFeversFood and Drug AdministrationHepatitis ALiverToxicity ePublished: 1 December 2008 Issue Published: 1 March 1985 PDF downloadLoading ...