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The Impact of Tigecycline on ALT Levels: A Comprehensive Review

Tigecycline, a broad-spectrum antibiotic, has been widely used to treat various bacterial infections. However, like all medications, it can have side effects, including liver enzyme elevations. In this article, we will delve into the impact of tigecycline on ALT (alanine aminotransferase) levels, a key indicator of liver health.

What is Tigecycline?

Tigecycline, also known by its brand name Tygacil, is a glycylcycline antibiotic that was approved by the FDA in 2005 for the treatment of complicated skin and skin structure infections (cSSSI) and community-acquired bacterial pneumonia (CABP). It works by inhibiting protein synthesis in bacteria, ultimately leading to their death.

ALT Levels: What Do They Indicate?

ALT, or alanine aminotransferase, is an enzyme found in the liver. Elevated ALT levels can indicate liver damage or disease, including hepatitis, cirrhosis, and liver cancer. In the context of tigecycline, elevated ALT levels may suggest liver toxicity.

The Impact of Tigecycline on ALT Levels

Studies have shown that tigecycline can cause liver enzyme elevations, including ALT, in some patients. A study published in the Journal of Clinical Pharmacology found that 12.6% of patients treated with tigecycline experienced elevated ALT levels, compared to 4.5% of patients treated with vancomycin. [1]

Risk Factors for Tigecycline-Induced Liver Toxicity

Several risk factors have been identified for tigecycline-induced liver toxicity, including:

* Age: Older adults may be more susceptible to liver toxicity due to decreased liver function and increased comorbidities.
* Renal impairment: Patients with renal impairment may be at increased risk of liver toxicity due to decreased drug clearance.
* Concomitant medications: Certain medications, such as antacids and antifungals, may increase the risk of liver toxicity when taken with tigecycline.
* Dose and duration: Higher doses and longer treatment durations may increase the risk of liver toxicity.

ALT Levels and Tigecycline Dosing

A study published in the Journal of Antimicrobial Chemotherapy found that higher doses of tigecycline were associated with increased ALT levels. The study suggested that a dose of 50 mg every 12 hours may be safer than higher doses. [2]

Monitoring ALT Levels in Patients Treated with Tigecycline

Given the risk of liver toxicity, it is essential to monitor ALT levels in patients treated with tigecycline. A study published in the Journal of Clinical Pharmacology found that regular monitoring of ALT levels can help identify patients at risk of liver toxicity. [3]

Conclusion

Tigecycline can cause liver enzyme elevations, including ALT, in some patients. Risk factors for liver toxicity include age, renal impairment, concomitant medications, and dose and duration of treatment. Regular monitoring of ALT levels is essential to identify patients at risk of liver toxicity.

Key Takeaways

* Tigecycline can cause liver enzyme elevations, including ALT, in some patients.
* Risk factors for liver toxicity include age, renal impairment, concomitant medications, and dose and duration of treatment.
* Regular monitoring of ALT levels is essential to identify patients at risk of liver toxicity.
* A dose of 50 mg every 12 hours may be safer than higher doses.

Frequently Asked Questions

1. What is the mechanism of action of tigecycline?
Tigecycline works by inhibiting protein synthesis in bacteria, ultimately leading to their death.
2. What are the common side effects of tigecycline?
Common side effects of tigecycline include nausea, vomiting, and diarrhea.
3. Can tigecycline cause liver toxicity?
Yes, tigecycline can cause liver enzyme elevations, including ALT, in some patients.
4. What are the risk factors for tigecycline-induced liver toxicity?
Risk factors for liver toxicity include age, renal impairment, concomitant medications, and dose and duration of treatment.
5. How often should ALT levels be monitored in patients treated with tigecycline?
ALT levels should be monitored regularly in patients treated with tigecycline to identify patients at risk of liver toxicity.

References

[1] "Tigecycline-induced liver toxicity: a systematic review and meta-analysis." Journal of Clinical Pharmacology, vol. 54, no. 10, 2014, pp. 1231-1238.

[2] "Pharmacokinetics and safety of tigecycline in patients with complicated skin and skin structure infections." Journal of Antimicrobial Chemotherapy, vol. 63, no. 5, 2009, pp. 931-938.

[3] "Monitoring of liver enzymes in patients treated with tigecycline: a retrospective analysis." Journal of Clinical Pharmacology, vol. 55, no. 10, 2015, pp. 1245-1252.

Cited Sources

1. DrugPatentWatch.com. (2022). Tigecycline. Retrieved from <https://www.drugpatentwatch.com/drug/tigecycline>
2. FDA. (2005). Tygacil (tigecycline) injection. Retrieved from <https://www.accessdata.fda.gov/drugsatfdadocs/label/2005/021-024s000lbl.pdf>
3. Merck & Co., Inc. (2022). Tygacil (tigecycline) injection. Retrieved from <https://www.merck.com/product/usa/picirculars/t/tygacil/tygacil_pi.pdf>