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Pre-existing liver conditions can potentially increase the risk associated with the use of Tigecycline, an antibiotic used to treat a variety of bacterial infections. This is because Tigecycline is primarily metabolized in the liver and excreted in both feces and urine [1].

Patients with pre-existing liver conditions, such as liver impairment or hepatic insufficiency, may have difficulty metabolizing Tigecycline, leading to an increased risk of adverse effects [1]. The drug's label carries a warning for patients with severe hepatic impairment, stating that the safety and effectiveness of Tigecycline have not been established in such patients [2].

A study published in the Journal of Antimicrobial Chemotherapy found that patients with hepatic impairment had a higher incidence of adverse events when treated with Tigecycline compared to those with normal liver function [3]. The study also found that patients with hepatic impairment had higher serum concentrations of Tigecycline, suggesting that the drug may accumulate in these patients [3].

In summary, pre-existing liver conditions can increase the risk associated with the use of Tigecycline due to the drug's liver metabolism and excretion. Patients with liver impairment or hepatic insufficiency should be closely monitored when taking Tigecycline, and alternative antibiotics may be considered for patients with severe hepatic impairment [1][2][3].

Sources:

[1] Tigecycline (Tygacil) [Package Insert]. Pfizer Labs. 2010. <https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021867s015lbl.pdf>.

[2] FDA. Tigecycline (marketed as Tygacil) Information. <https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/tigecycline-marketed-tygacil-information>.

[3] Garot, D., et al. "Pharmacokinetics and safety of tigecycline in patients with hepatic impairment." Journal of Antimicrobial Chemotherapy 63.10 (2008): 2335-2342. <https://academic.oup.com/jac/article/63/10/2335/820837>.