A patient who underwent posterior lumbar interbody fusion was treated with imrecoxib, the patient’s liver biochemical examination was abnormal. Follow taking polyene phosphatidylcholine injection combined with glutathione for liver protection, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (AKP) still increased progressively, with peaks of 404.7, 122.8 and 255.1 U·L^-1, respectively. With stopping the use of imrecoxib, and adjusting the liver protection treatment of polyene phosphatidylcholine injection combined with compound glycyrrhizin injection, ALT, AST and AKP decreased gradually before discharge and were 54.6, 21.2, 137.2 U·L^-1, respectively. Associations were evaluated by RUCAM rating scale, with an imrecoxib association score of 8, and it may be causing liver damage of this patient. The hepatotoxicity should be vigilant and the liver function should be monitored in application of imrecoxib to ensure the safety of drug in patients.

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