Highlights
- Medications like some antibiotics and antiepileptic drugs, as well as herbal and dietary supplements including bodybuilding supplements can damage the liver
- The liver damage could be due to a toxic effect or an allergic reaction
- The liver usually recovers on stopping the implicated medication. Severe damage of the liver may require liver transplantation
Some people suffer from liver injury with a drug due to an allergic reaction. Such reactions are difficult to predict – they can affect just any one at any time – and are therefore almost impossible to prevent.
Drugs that are mentioned in the article as hepatotoxic vary from over-the-counter medications to medications used for serious conditions. They include:
- Acetaminophen - It is a common fever-reducing medication and painkiller. The drug is extremely safe and unlike several other over-the-counter painkillers, is even recommended in patients prone to stomach ulcers. However, the patients should be warned to restrict to the maximum recommended dose since a high dose can damage the liver
- Antibiotics - Commonly used antibiotics like amoxicillin clavulanate, fluoroquinolones, erythromycin, minocycline, azithromycin and trimethoprim-sulfamethoxazole.
- Anti-epilepsy drugs like phenytoin and carbamazepine.
It is also important to remember that drug-induced liver disease is extremely rare. The author points out that some people may have a higher risk of developing liver disease. These include:
- Genetically predisposed individuals
- Older or younger individuals
- Females as compared to males (pregnancy also increases the risk)
- Those with pre-existing liver disease, smokers and alcohol consumers
Diagnosing Drug-Induced Liver Injury
A drug-induced liver injury is diagnosed based on
- The medical history of the patient who indicates the appearance of certain symptoms within up to 6 months of intake of a medication
- Physical examination which may reveal signs of liver injury like jaundice
- Laboratory tests like blood tests, urine tests and stool tests
Reference:
- Lisi DM. Drug-Induced Liver Injury: An Overview. US Pharm. 2016;41(12):30-34.