Clopidogrel-induced hepatotoxicity and fever

A 59-year-old woman developed fever and elevated hepatic enzyme levels within days of starting clopidogrel, which had been prescribed in conjunction with a percutaneous coronary intervention. When she discontinued the clopidogrel, her liver enzyme levels returned to baseline and her fever disappeared. These signs and symptoms returned after rechallenge with clopidogrel. Monitoring for fever and elevation of liver enzyme levels in patients taking clopidogrel may be warranted. if a patient has signs of hepatotoxicity with or without fever, discontinuation of clopidogrel should be considered, along with substitution with ticlopidine if clinically warranted.