The pharmacokinetics of bendazac-lysine and 5-hydroxybendazac, its main metabolite, in patients with hepatic cirrhosis

Hepatotoxicity due to lysine salt of bendazac

BACKGROUND

The lysine salt of bendazac is a non-steroidal anti-inflammatory agent, and it is marketed exclusively for the treatment of cataracts. We report two cases of possible hepatotoxicity due to the use of bendazac lysine.

METHODS

Laboratory tests, serologic tests, abdominal sonography and scan were performed to study liver disease.

RESULTS

Reversible increases of the hepatic enzymes were found in both cases. Anemia was also found in one of the cases (case 1).

CONCLUSIONS

Abnormal liver test results could be related to a possible liver injury attributed to the use of bendazac lysine.

Bendazac lysine. A review of its pharmacological properties and therapeutic potential in the management of cataracts

Bendazac is an oxyacetic acid with anti-inflammatory, antinecrotic, choleretic and antilipidaemic properties, but its principal effect is to inhibit the denaturation of proteins. The lysine salt, which is better absorbed than the parent compound after oral administration, has been evaluated as a treatment for cataract, a condition which appears to result mainly from the denaturation, aggregation and precipitation of proteins within the lens. Results from a very small number of preliminary studies using objective photographic and densitometric methods have suggested that oral bendazac lysine, usually at a dosage of 500 mg 3 times daily, can stabilise the progression of lens opacification in patients with cataract. Significant improvements in individual and mean visual acuities in treated patients have been reported by several studies, but this parameter is not universally accepted as a reliable index of lens status. Preliminary studies evaluating bendazac lysine 0.5% eyedrops have reported comparable results to those obtained with oral treatment. Overall, tolerability of the drug has been good in studies to date. A dose-related laxative effect and other gastrointestinal disturbances are the most common adverse effects associated with oral therapy, and a transient burning sensation is the most commonly reported symptom occurring with eyedrop application. Bendazac lysine is one of a number of agents which have been introduced for the management of cataract. Although the results of preliminary studies have suggested that the drug may be useful for delaying the progression of cataract, further clinical studies using proven objective methods are required to fully establish its value in the management of this condition and its long term tolerability.