Two hemodialysis patients with central nervous system side effects due to lafutidine

Abstract

We report two hemodialysis patients with central nervous system side effects, such as hallucination and pseudopsia due to lafutidine administration. Case 1, a 64-year-old man, developed cholestatic hepatic injury followed by hallucination and pseudopsia t e n days after lafutidine administration at a dose o f 20mg/day. Case 2, a 55-year-old man, complained o f hallucination after six months of lafutidine administration at a dose of 20mg/day. The symptoms disappear e d after drug cessation in both cases. The plasma lafutidine level in case 2 before hemodialysis was 918ng/mL, which was approximately 4.5 times higher than the normal value. These findings indicate that the symptoms were derived by lafutidine intoxication. Although the urinary excretion rate of lafutidine is known to be 10.9%, its bioavailability is still not ful l y understood. Therefore, it may not be easy to establish the optimal individual dosage based on renal functi o n data. However, we should be prudent when prescribing lafutidine for hemodialysis patients, as it is recommend e d for H2-blockers of the renal excretion type. OE" c OEh Žq ŽO • N • a‰@ –ò • Ü • " • 569-0077'å • ã • { • ‚'Î Žs–ìOE© '¬3-6 Keiko Harada Tel: 0726-76-0001 Fax: 0726-73-9848 • k Žó • t: • ½ • ¬16 " N3OEŽ15 " ú, Žó— • : • ½ • ¬16 " N11OEŽ14 " ú • l