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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

Chronic liver diseases such as hepatitis, fatty liver, or cholestasis can lead to the necrosis (death) of liver cells. Scar tissue forms as part of the healing process that is associated with the dying liver cells, and severe scarring of the liver can lead to cirrhosis.

The most common example of drug-induced cirrhosis is alcoholic cirrhosis . Examples of drugs that can cause chronic liver diseases and cirrhosis include methotrexate (Rheumatrex), amiodarone (Cordarone), and methyldopa (Aldomet). Please read the article on Cirrhosis for more information.

Normally, blood from the intestines is delivered to the liver via the portal vein, and the blood leaving the liver for the heart is carried via the hepatic veins into the inferior vena cava (the large vein that drains into the heart). Certain drugs can cause blood clots to form (thrombosis) in the hepatic veins and in the inferior vena cava. Thrombosis of the hepatic vein and inferior vena cava can lead to an enlarged liver, abdominal pain, fluid collection in the abdomen (ascites), and liver failure. This syndrome is called the Budd Chiari syndrome. The most important drugs that cause Budd-Chiari syndrome are birth control pills (oral contraceptives). Birth control pills also can cause a related disease called veno-occlusive disease in which blood clots only in the smallest hepatic veins. Pyrrolizidine alkaloids found in certain herbs (e.g., borage, comfrey) also can cause veno-occlusive disease.