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Had radical nephrectomy and UTI. Have enlarged prostate and take Veltam F. On oxflacin. High bilirubin level

Jun 2015
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General & Family Physician
Practicing since : 2011
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I am 78 years old and had right radical nephrectomy way back in 1990. Ialso have an enlarged prostate and take Veltam F everyday. I am having other age related issues like pain in the knees and inadequate vision. Otherwise I am able to live a relatively healthy life. Recently, I was hospitalized and it came out that there was UTI and the infection had spread to the lungs/chest. That was also cured after completing the medicines prescribed. Now, I do not feel like eating anything particularly sweet items and fruits. I feel like eating only those foods which sour and salty. My total bilirubin is 1.0 and the indirect bilirubin is 0.9. I did not have enough food for the past 4-5 days. What could be my problem as the doctor has given me saline and oxflacin. I felt relief immediately after that injection yesterday but it is back to square one again now.
Posted Fri, 31 May 2013 in General Health
Answered by Dr. Polash Sannigrahi 7 hours later

Thanks for your query.

I have gone through the history as mentioned in the post & also the investigation report as attached with the post.

You have been taking Veltam F for enlarged prostate.
It contains:
1. Finasteride- it inhibits formation of the hormone which causes prostate enlargement.
2. Tamsulosin- it relaxes the bladder muscles & prevents the urinary symptoms.

Though the levels of total & indirect bilirubin are slightly on the higher side (total bilirubin is 1.0 and indirect bilirubin is 0.9), all other liver function test parameters are within normal limits and in the absence of any specific symptom & sign, these increased levels cannot be considered significant.

As you had been admitted in hospital recently on account of UTI & Respiratory infections, and took antibiotic therapy for treatment, persistence of certain side effects of the medications can be suspected for your symptoms.

The reasons for increased affinity towards salty & sour foods and decreased appetite can be:
1. Persistence of the infective agent in the body.
2. Electrolyte deficiency in the body- increased liking of sour & salty foods indicating the body’s need for sodium & other electrolytes.
3. Altered sensation of taste buds due to prolonged anti biotic therapy.
4. Inadequate hydration status of the body- saline was given to you to correct this.
5. Deficiencies of certain nutrients like Iron, Vitamin B 12, Folic acid, etc. which interferes with blood formation- and anemia is known to cause craving & decreased appetite.

Investigations like complete blood count, serum electrolytes, and estimation of blood pressure & blood sugar levels will be helpful in this regard.

Ofloxacin is a broad-spectrum antibiotic used in a wide range of infections.
Temporary relief will be obtained by infusion of saline, but unless the hydration & nutrition status is maintained, symptoms will keep recurring.

One more thing, Ofloxacin on prolonged use has been found to cause Liver damage, Tendon damage in elderly individuals as well as the dose should be reduced in individuals with compromised kidney functions.
So, kindly discuss regarding this matter with your treating Doctor.

Meanwhile, maintain adequate hydration & take a healthy balanced diet.
There is no need to worry, you will be fine.

Wishing you a good health.
Please let me know if I need to clarify further.
Thanks & take care.
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