Liver Disease

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)
    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.

What are the causes of liver disease (drug-induced liver disease)?

Drug-induced liver disease

Liver cells may become temporarily inflamed or permanently damaged by exposure to medications or drugs. Some medications or drugs require an overdose to cause liver injury while others may cause the damage even when taken in the appropriately prescribed dosage.

Taking excess amounts of acetaminophen (Tylenol, Panadol) can cause liver failure. This is the reason that warning labels exist on many over-the-counter medications that contain acetaminophen and why prescription narcotic-acetaminophen combination medications (for example, Vicodin, Lortab, Norco, Tylenol #3) limit the numbers of tablets to be taken in a day. For patients with underlying liver disease or those who abuse alcohol, that daily limit is lower and acetaminophen may be contra-indicated in those individuals.

Statin medications are commonly prescribed to control elevated blood levels of cholesterol. Even when taken in the appropriately prescribed dose, liver inflammation may occur. This inflammation can be detected by blood tests that measure liver enzymes. Stopping the medication usually results in return of the liver function to normal.

Niacin is another medication used to control elevated blood levels of cholesterol, but liver inflammation for this medication is related to the dose taken. Similarly, patients with underlying liver disease may be at higher risk of developing liver disease due to medications such as niacin. Recent studies have found that niacin may not be as effective as previously thought in controlling high cholesterol. Patients who take niacin may want to see their health care professional to determine if other treatment options may be appropriate.

There are numerous other medications that may cause liver inflammation, most of which will resolve when the medication is stopped. These include antibiotics such as nitrofurantoin (Macrodantin, Furadantin, Macrobid), amoxicillin and clavulanic acid (Augmentin, Augmentin XR), tetracycline (Sumycin), and isoniazid (INH, Nydrazid, Laniazid). Methotrexate (Rheumatrex, Trexall), a drug used to treat autoimmune disorders and cancers, has a variety of side effects including liver inflammation that can lead to cirrhosis. Disulfiram (Antabuse) is used to treat alcoholics and can cause liver inflammation.

Some herbal remedies and excessive amounts of vitamins can cause hepatitis, cirrhosis and liver failure. Examples include vitamin A, kava kava, ma-huang, and comfrey.

Many mushrooms are poisonous to the liver and eating unidentified mushrooms gathered in the wild can be lethal. Continue Reading

Reviewed on 7/15/2015
References
REFERENCES:

Fauci, Anthony S., et al. Harrison's Principles of Internal Medicine. 17th ed. United States: McGraw-Hill Professional, 2008.

National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases. "Liver."

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