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Medical Author:

Dennis Lee, MD

Dennis Lee, MD

Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.

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Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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In this Article

• What is drug-induced liver disease?
• What is the liver?
• What are the symptoms of liver disease?
• How do drugs cause liver disease?
• What types of liver disease do drugs cause?
• Elevated blood levels of liver enzymes
• Acute and chronic hepatitis
• Acute liver failure
• Cholestasis
• Steatosis (fatty liver)
• Cirrhosis
• Hepatic vein thrombosis
• How is drug-induced liver disease diagnosed?
• What is the treatment for drug-induced liver disease?
• What are some important examples of drug-induced liver disease?
• Patient Comments: Drug-Induced Liver Disease - Causes
• Patient Comments: Drug-Induced Liver Disease - Describe Your Experience
• Find a local Gastroenterologist in your town
• Drug Induced Liver Disease Index

Certain drugs can cause acute and chronic hepatitis (inflammation of liver cells) that can lead to necrosis (death) of the cells. Acute drug-induced hepatitis is defined as hepatitis that lasts less than 3 months, while chronic hepatitis lasts longer than 3 months. Acute drug-induced hepatitis is much more common than chronic drug-induced hepatitis by a ratio of 9:1.

Typical symptoms of drug-induced hepatitis include:

• loss of appetite,
• nausea,
• vomiting,
• fever,
• weakness,
• tiredness, and
• abdominal pain.

In more serious cases, patients can develop dark urine, fever, light-colored stool, and jaundice (a yellow appearance to the skin and white portion of the eyes). Patients with hepatitis usually have high blood levels of AST, ALT, and bilirubin. Both acute and chronic hepatitis typically resolve after stopping the drug, but sometimes acute hepatitis can be severe enough to cause acute liver failure (see discussion later in this article), and chronic hepatitis can on rare occasions, lead to permanent liver damage and cirrhosis.

Examples of drugs that can cause acute hepatitis include acetaminophen (Tylenol), phenytoin (Dilantin), aspirin, isoniazid (Nydrazid, Laniazid), diclofenac (Voltaren), and amoxicillin/clavulanic acid (Augmentin).

Examples of drugs that can cause chronic hepatitis include minocycline (Minocin), nitrofurantoin (Furadantin, Macrodantin), phenytoin (Dilantin), propylthiouracil, fenofibrate (Tricor), and methamphetamine ("ecstasy")..