社團法人臺灣臨床藥學會

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【案例報告】疑似Danazol引起肝功能異常與乳酸脫氫酶 (LDH) 上升的案例報告
Danazol-Induced Liver Enzymes and Lactate Dehydrogenase Elevation: A Case Report
Danazol,血小板低下性紫斑症,肝功能異常,乳酸脫氫酶上升、Danazol, Idiopathic Thrombocytopenic Purpura, Liver Enzymes Elevation, Lactate Dehydrogenase Elevation
李彥樺Yen-Hua Li 、吳奕璋Yih-Jang Wu 、王春玉Chun-Yu Wang 、張明聰Ming-Tsung Chang*
1新光醫療財團法人新光吳火獅紀念醫院藥劑部
衛生福利部核准Danazol 適應症為子宮內膜異位症、囊狀慢性乳腺炎、乳腺肥大、乳痛、月經過多、纖維性囊腫性乳房疾病,但臨床上也會用來治療特異性血小板低下性紫斑症 (Idiopathic Thrombocytopenic Purpura, ITP),是屬於核准適應症外的用途,常見副作用有:痤瘡、體重上升、掉髮、心悸等,嚴重副作用包括:昏厥、HDL 下降、肝酵素與乳酸脫氫酶 (Lactate Dehydrogenase, LDH) 上升、肝衰竭等。根據文獻指出,每日劑量400 mg 以上可能會顯著增加肝酵素,治療期間應密切監測肝功能。此外,有明顯肝功能受損者,禁止使用。

Danazol is indicated for endometriosis, chronic cystic mastitis, breast enlargement, breast pain, menorrhagia, fibrocystic breast disease, approved by Ministry of Health and Welfare. Moreover, it is also used clinically in the treatment of idiopathic thrombocytopenic purpura (ITP), part of the off-label indication. The common adverse reactions are acne, weight gain, alopecia, palpitations and serious adverse reactions include: syncope, decreased high-density lipoprotein level, elevated levels of transaminase and lactate dehydrogenase (LDH) and liver failure. According to our literature review, Danazol 400 mg daily or higher dose, may significantly increase liver enzymes, therefore hepatic function should be closely monitored during treatment. In addition, those with markedly impaired hepatic function are prohibited.
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