Hepatotoxicity: Drug-Induced Liver Damage

Many drugs can cause hepatotoxicity, the toxic destruction of the liver. Eight of every thousand cases of hepatitis are caused by medications. The liver reacts to the medication and becomes inflamed. Treatment is relatively straightforward: if medication side effects cause drug-induced hepatitis, discontinuing or changing the medication usually resolves the issue within a few weeks.

 

The timing of the onset of hepatotoxicity varies according to the type of medication and the length of time it's taken. Side effects of antibiotics may fail to appear for several days, while an overdose of analgesics containing acetaminophen may cause damage within hours.

Symptoms of hepatotoxicity usually resemble those of viral hepatitis, although some cases have no noticeable symptoms. Common side effects of hepatotoxins include:

A variety of medications can cause organ damage. Patients with a history of liver disease should check with their doctor before starting new medications. Antibiotics such as erythromycin can result in hepatitis-like side effects, as can analgesics, steroid-based medications, immunosuppressants, oral contraceptives, statin drugs and any medication designed to alter liver function.

Acetaminophen: Analgesics containing acetaminophen/paracetamol should be avoided by people with histories of liver problems. Overdosing on acetaminophen can cause hepatotoxicity within hours.

Erythromycin: This is a common antibiotic known to cause jaundice and other hepatitis-like symptoms.

Halothane: Halothane is an inhaled general anesthetic. Halothane has been known to cause severe side effects and, in some cases, death has resulted from liver damage.

Methotrexate: Used to treat rheumatoid arthritis and other diseases of the immune system, methotrexate suppresses overly active immune systems. Regular blood tests are usually required for people taking methotrexate. Mixing this medication with alcohol greatly increases the chance of liver damage.

Statin Drugs: Popular cholesterol-reducing medications, statin drugs prevent the liver from producing a substance necessary to make cholesterol.

Resources

American Academy of Family Physicians. (updated 2003). Methotrexate.

Beers, M. H., & Berkow, R., ed. (1999). The Merck Manual of Diagnosis and Therapy, 17th Edition. NJ: Merck Research Laboratories.

Hepatitis Central. (2005). Toxic hepatitis and drug induced hepatitis.

National Library of Medicine. (updated 2004). Drug-induced hepatitis.MedlinePlus Medical Encyclopedia.

National Library of Medicine. (updated 2004). Jaundice: Yellow skin. MedlinePlus Medical Encyclopedia.

Wisconsin Department of Health and Family Services. (updated 2004). Naphthene.