From the Research
Introduction to Zorvolex (Diclofenac) and Liver Enzymes
Zorvolex, also known as Diclofenac, is a nonsteroidal anti-inflammatory drug (NSAID) used to treat various conditions such as pain, inflammation, and arthritis. One of the potential side effects of NSAIDs, including Diclofenac, is the elevation of liver enzymes, which can indicate liver damage or disease.
Mechanism of Liver Injury
The mechanism of liver injury caused by Diclofenac is not fully understood, but it is thought to be related to the drug's metabolism and its effects on the liver cells [ 1 ]. The liver plays a crucial role in metabolizing drugs, and some drugs, including Diclofenac, can cause liver injury as a result of this process.
Patterns of Liver Enzyme Elevation
There are different patterns of liver enzyme elevation, including:
- A predominant increase in transaminase activities, which reflects a disturbance of hepatocellular integrity [ 2 ]
- A high serum alkaline phosphatase and γ-glutamyltranspeptidase activities, indicating cholestatic liver diseases [ 2 ]
- A predominant rise in γ-glutamyl transpeptidase, which is observed in alcoholic or non-alcoholic fatty liver disease and infiltrating liver diseases [ 2 ]
Diagnosis and Management
The diagnosis of elevated liver enzymes requires a thorough evaluation, including laboratory tests and clinical assessment [ 3 ]. The management of elevated liver enzymes depends on the underlying cause and may involve discontinuation of the offending drug, treatment of the underlying disease, and monitoring of liver function tests.
Treatment with Diclofenac
When treating patients with Diclofenac, it is essential to monitor liver function tests regularly, especially in patients with pre-existing liver disease or risk factors for liver disease [ 4 ]. The dosage of Diclofenac should be adjusted according to the patient's response and liver function tests.
Caveats and Differentials
It is essential to consider other potential causes of elevated liver enzymes, including:
- Viral hepatitis
- Genetic liver diseases
- Drug-induced liver diseases
- Alcoholic or non-alcoholic fatty liver disease
- Infiltrating liver diseases
- Extrahepatic diseases, such as gallstones or tumors
Conclusion
In conclusion, Zorvolex (Diclofenac) can cause elevated liver enzymes, and it is essential to monitor liver function tests regularly when treating patients with this drug. The diagnosis and management of elevated liver enzymes require a thorough evaluation and consideration of other potential causes. By understanding the mechanisms of liver injury and the patterns of liver enzyme elevation, healthcare providers can provide better care for patients taking Diclofenac and other NSAIDs [ 5 ].