Flutamide-induced hepatotoxicity: A case report

Abstract

Flutamide is a non-steroidal anti-androgen drug effective in the management of prostatic carcinoma. The drug appears to be well tolerated with mild gastrointestinal adverse events and gynecomastia. Flutamide-induced hepatotoxicity may range from minor elevation in liver enzymes to hepatic failure. Here, we tried to discuss the possibility of hepatotoxicity induced by flutamide as antiandrogen therapy in a patient with prostatic adenocarcinoma. Here we present a 75-year-old man who commenced flutamide as a postoperative anti-androgen for prostatic adenocarcinoma for two months. He had markedly elevated levels of liver enzymes due to acute liver failure and subsequent multi-organ failure. The patient died after the failure of the resuscitation measures. The temporal relationship between the flutamide initiation and the emergence of hepatotoxicity is not clear, with a possible latency of 12-16 weeks. Careful monitoring of liver function test during flutamide therapy is essential to prevent serious hepatotoxicity.