Drug-induced liver disease: Drug-induced liver diseases are diseases of the liver that are caused by physician-prescribed medications, over-the-counter medications, vitamins, hormones, herbs, illicit ("recreational") drugs, and environmental toxins.
Many drugs can cause liver diseases. Examples include pain-relievers such as acetaminophen and nonsteroidal antiinflammatory drugs (NSAIDs), certain antibiotics, antidepressants, anti-cancer agents, and drugs used in controlling high blood pressure, high cholesterol , diabetes, and irregular heart rhythms.
Drug-induced liver diseases vary widely in severity. The spectrum of diseases include 1) abnormal blood levels of liver enzymes without symptoms, 2) hepatitis (inflammation of liver cells), 3) necrosis (death of liver cells), 4) steatosis (accumulation of fat in the liver), 5) cirrhosis (advanced scarring of the liver), 6) fulminant hepatitis (severe, life-threatening liver failure), and 7) blood clots of the veins within the liver.
Patients with mild drug induced liver disease may have few or no symptoms or signs. Patients with more serious disease (such as hepatitis and necrosis) develop symptoms and signs such as fatigue, weakness, vague abdominal pain, loss of appetite, yellowing of the skin or jaundice due to the accumulation of bilirubin in the blood, itching, and easy bruising due to decreased production of blood clotting factors by the diseased liver. Patients with advanced cirrhosis can develop fluid accumulation in the legs (edema) and abdomen (ascites), mental confusion or coma, kidney failure, vulnerability to bacterial infections, and gastrointestinal bleeding.
The diagnosis of drug-induced liver disease is based on 1) patients' symptoms (such as loss of appetite, nausea, fatigue, itching, and dark urine), 2) findings on the physical examination (such as jaundice, enlarged liver), 3) finding abnormal blood levels of liver enzymes, bilirubin, and blood clotting times), 4) history of recent initiation of a drug that has been known to cause liver disease, and 5) performing tests to exclude hepatitis A, hepatitis B, hepatitis C, and other causes of abnormal liver blood tests such as alcoholic liver disease, primary biliary cirrhosis (PBC), liver tumors, and gallstones.
The most important treatment for drug-induced liver disease is stopping the drug that is causing the liver disease.
Also spelled, drug induced liver disease, drug induced liver diseases.
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Last Editorial Review: 5/13/2016