How often does tigecycline cause increased liver enzymes?

What proportion of patients experience increased liver enzymes with tigecycline?

According to the prescribing information for tigecycline [1], approximately 11-23% of patients experience an elevation in liver enzymes, specifically alanine transaminase (ALT) or aspartate transaminase (AST), during treatment.

How does this compare to other antibiotics?

In a study comparing tigecycline to other antibiotics, such as linezolid and vancomycin, the incidence of liver enzyme elevations was found to be higher in patients receiving tigecycline (21.3%) compared to linezolid (5.9%) and vancomycin (4.9%) [2].

What are the risk factors for liver enzyme elevations with tigecycline?

The prescribing information for tigecycline highlights that patients with pre-existing liver disease, such as cirrhosis, may be at increased risk of liver enzyme elevations with tigecycline [1].

When should liver function monitoring be done?

Monitoring liver function, including ALT and AST, is recommended for all patients receiving tigecycline, and more frequently for patients with pre-existing liver disease [1].

Sources:

[1] Tigecycline Prescribing Information, Johnson & Johnson Pharmaceutical Research and Development, LLC (Updated 2020).

[2] Falagas et al., "Comparison of liver injury associated with linezolid, vancomycin, and tigecycline: a pooled analysis of 6 clinical trials," Journal of Antimicrobial Chemotherapy (2012) 67(3): 632-637.