Health Encyclopedia

Drug-induced hepatitis

Definition

Drug-induced hepatitis is inflammation of the liver that may occur when you take certain medications.

Alternative Names

Toxic hepatitis

Causes, incidence, and risk factors

The liver helps the body break down certain drugs. However, the way it does so differs from person to person. Therefore, may different drugs can cause drug-induced hepatitis.

Painkillers and fever reducers that contain acetaminophen are a common cause of liver inflammation. These medications can damage the liver when taken in doses that are not much greater than the recommended therapeutic dose.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen may also cause drug-induced hepatitis.

Other drugs that can lead to liver inflammation include:

Amiodarone
Anabolic steroids
Birth control pills
Chlopromazine
Erythromycin
Halothane
Methyldopa
Isoniazid (used to treat tuberculosis)
Methotrexate
Statins

Symptoms

Abdominal pain
Dark urine
Diarrhea
Headache
Jaundice
Fatigue
Loss of appetite
Nausea and vomiting
White or clay-colored stools

Signs and tests

Blood tests will be done to check liver function. Liver enzymes may be increased.

A physical exam may reveal an enlarged liver and abdominal tenderness in the right upper part of the belly area.

Treatment

There is no specific treatment for drug-induced hepatitis other than stopping the drug that is causing the problem.

You should rest during the acute phase of the disease, when the symptoms are most severe. If you have significant nausea and vomiting, fluids given through a vein may be needed.

Those with acute hepatitis should avoid physical exertion, alcohol, acetaminophen, and any other substances that are harmful to the liver.

Expectations (prognosis)

Usually, drug-related hepatitis goes away within days or weeks after the offending drug is stopped.

Complications

Liver failure is a possible but rare complication of drug-induced hepatitis.

Calling your health care provider

Call your health care provider if symptoms of hepatitis develop after you start a new medication.

Call your health care provider if you have been diagnosed with drug-induced hepatitis and symptoms do not improve after the offending medication is stopped. Also call if any new symptoms develop.

Prevention

If you use over-the-counter medications containing acetaminophen (Tylenol), never use more than the recommended dose. If you drink heavily or regularly, you should completely avoid these medications or discuss safe doses with your physician.

If you have liver disease, it is extremely important to tell your doctor about all the medicines you take. You should avoid the following medications if you have liver disease:

6 - Mercaptopurine
Acetaminophen
Alcohol
Allopurinol
Androgens
Birth control pills
Carbamazepine
Chlorpromazine
Halothane
Hydralazine
Isoniazid
Methotrexate
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen
Phenytoin
Valproic acid

This list is not all-inclusive.

Your health care provider can recommend safe medications, including over-the-counter medications, for other medical conditions you may have.

References

Goldman L, Ausiello D. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.

Review Date:11/13/2007
Reviewed By:Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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