From the Guidelines
Ceftin (cefuroxime) is not commonly associated with elevated liver function tests (LFTs), but monitoring may be necessary in certain cases, particularly in patients with pre-existing liver disease or those on prolonged courses of the medication. The risk of liver injury with cefuroxime is considered low compared to other antibiotics. When LFT elevations do occur, they are typically mild and transient, resolving after discontinuation of the medication. According to the most recent guidelines, monitoring of liver function is conditionally recommended for certain medications, such as tocilizumab, with alterations in administration if monitoring reveals elevated LFT results 1. However, there is no direct evidence in the provided studies that specifically addresses the risk of elevated LFTs with cefuroxime.
Some key points to consider:
- Patients with pre-existing liver disease may be at higher risk for this side effect
- The mechanism behind cefuroxime-induced liver injury is not fully understood but may involve an immune-mediated response or direct toxicity to liver cells
- If a patient taking Ceftin develops symptoms such as jaundice, dark urine, right upper quadrant pain, or unusual fatigue, they should contact their healthcare provider immediately as these could indicate liver problems
- Regular monitoring of liver function may be appropriate in patients on prolonged courses of cefuroxime, particularly those with underlying liver conditions, although the exact monitoring schedule is not specified in the provided studies.
It's essential to weigh the benefits and risks of cefuroxime treatment and consider alternative antibiotics if there are concerns about liver function. However, based on the available evidence, cefuroxime is not typically associated with significant liver toxicity, and monitoring can be tailored to individual patient risk factors 1.
From the FDA Drug Label
Hepatic: Transient rise in SGOT and SGPT (1 in 25 patients), alkaline phosphatase (1 in 50 patients), LDH (1 in 75 patients), and bilirubin (1 in 500 patients) levels has been noted
- Elevated Liver Function Tests (LFTs) have been reported in patients taking Ceftin (Cefuroxime), including:
- Transient rise in SGOT and SGPT in 1 in 25 patients
- Transient rise in alkaline phosphatase in 1 in 50 patients
- Transient rise in LDH in 1 in 75 patients
- Transient rise in bilirubin in 1 in 500 patients 2 Therefore, Ceftin (Cefuroxime) can cause elevated LFTs.
From the Research
Ceftin (Cefuroxime) and Elevated Liver Function Tests (LFTs)
- There is limited direct evidence on Ceftin (Cefuroxime) causing elevated Liver Function Tests (LFTs). However, a study from 1980 3 found that cefuroxime treatment seems to be well tolerated in patients with signs of impaired metabolic liver function at the start of treatment.
- The study 3 involved 15 patients and found that only one patient had an increase in galactose half-life during treatment, who was an old diabetic with prostatic cancer.
- Other studies have investigated the hepatotoxicity of other cephalosporins, such as ceftazidime 4, ceftriaxone 5, 6, but not specifically cefuroxime.
- A study on ceftazidime 4 found that it can cause a rapid rise in liver function tests (LFTs) in a hepatocellular pattern, but this was a rare case and not directly related to cefuroxime.
- Studies on ceftriaxone 5, 6 have found an association between high-dose ceftriaxone and liver injury, but these findings may not be directly applicable to cefuroxime.
- Another study 7 found that idiosyncratic reactions are the most common cause of abnormal liver function tests in patients with cystic fibrosis, but this study did not specifically investigate cefuroxime.