Drug-Induced Liver Injury From a Novel Antifungal – Olorofim
Abstract
Olorofim, an orotomide antifungal with orphan designation for coccidioidomycosis, has not been previously linked to drug-induced liver injury. We present a case of drug-induced liver injury in a 67-year-old man treated with olorofim for refractory disseminated coccidioidomycosis. The patient experienced an acute, almost 30-fold increase in liver enzymes in a hepatocellular pattern after administration of olorofim, followed by a rapid downtrend over the next few weeks. Rechallenge at a reduced dose did not reproduce the transaminase elevations, consistent with a probable Roussel-Uclaf Causality Assessment Method score of 8. Close hepatic monitoring and dose considerations are warranted as olorofim moves toward broader clinical use.
Fields of Study & Subjects
Fungal Infections and Studies
Antifungal resistance and susceptibility
Drug-Induced Hepatotoxicity and Protection
Publication details
- Journal / source
- ACG Case Reports Journal
- Publisher
- Ovid Technologies (Wolters Kluwer Health)
- Volume
- 13
- Issue
- 6
- Pages
- e02116–e02116
- Publication date
- 28 May 2026
- Language
- EN