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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

The diagnosis of drug-induced liver diseases often is difficult. Patients may not have symptoms of liver disease or may have only mild, nonspecific symptoms. Patients may be taking multiple drugs, which makes it difficult to identify the offending drug. Patients also may have other potential causes of liver diseases such as non-alcoholic fatty liver disease (NAFLD) and alcoholism.

The diagnosis of liver disease is based on a patient's symptoms (such as loss of appetite, nausea, fatigue, itching, and dark urine), findings on the physical examination (such as jaundice, enlarged liver), and abnormal laboratory tests (such as blood levels of liver enzymes or bilirubin and blood clotting times). If a patient has symptoms, signs, and abnormal liver tests, doctors then try to decide whether drug(s) are causing the liver disease by:

1. Taking a careful history of alcohol consumption to exclude alcoholic liver disease.
2. Performing blood tests to exclude viral hepatitis B and hepatitis C , and to exclude chronic liver diseases such as autoimmune hepatitis and primary biliary cirrhosis (PBC).
3. Performing abdominal ultrasound or computerized tomography (CT) scan of the liver to exclude gallbladder disease and tumors of the liver.
4. Taking a careful history of ingestion-particularly recent initiation--of drugs that are commonly associated with liver disease.