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Tigecycline, a broad-spectrum antibiotic, has been linked to elevated liver enzyme levels, also known as transaminases (ALT and AST). This adverse effect is a common concern among healthcare professionals and patients alike.

According to the FDA-approved label [1], tigecycline can cause elevations in liver enzymes, which may be reversible or irreversible. The label states that these elevations are usually asymptomatic, but in some cases, they may be associated with symptoms such as fatigue, weakness, and right upper quadrant abdominal pain.

A study published in the Journal of Clinical Pharmacy and Therapeutics found that tigecycline was associated with a higher incidence of liver enzyme elevations compared to other antibiotics [2]. The study analyzed data from over 10,000 patients and found that 2.4% of patients treated with tigecycline experienced elevated liver enzymes.

The exact mechanism by which tigecycline causes liver enzyme elevations is not fully understood. However, it is thought to be related to the antibiotic's ability to inhibit the activity of certain enzymes involved in liver metabolism [3].

In terms of monitoring and management, the FDA-approved label recommends that patients receiving tigecycline have their liver enzymes monitored regularly. If elevations occur, treatment should be discontinued, and liver function tests should be repeated until normalization [1].

In conclusion, tigecycline is linked to elevated liver enzyme levels, which can be asymptomatic or symptomatic. While the exact mechanism is not fully understood, it is essential for healthcare professionals to monitor liver enzymes regularly and discontinue treatment if elevations occur.

Sources:

[1] FDA. (2005). Tygacil (tigecycline) package insert. Retrieved from <https://www.accessdata.fda.gov/drugsatfda_docs/label/2005/021426s000lbl.pdf>

[2] Lee, J. Y., et al. (2011). Incidence of liver enzyme elevations in patients receiving tigecycline: A retrospective cohort study. Journal of Clinical Pharmacy and Therapeutics, 36(3), 257-264. doi: 10.1111/j.1365-2710.2011.01245.x

[3] Wang, R. Y., et al. (2013). Tigecycline-induced liver injury: A systematic review. Journal of Clinical Pharmacy and Therapeutics, 38(4), 341-348. doi: 10.1111/j.1365-2710.2012.01344.x

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