Drug-induced hepatitis
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Drug-induced hepatitis

Definition

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

See also:

Alternative Names

Toxic hepatitis

Causes

The liver helps the body break down certain drugs. However, the way it does so differs from person to person. Therefore, many 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
  • Chlorpromazine
  • Erythromycin
  • Halothane
  • Methyldopa
  • Isoniazid (used to treat tuberculosis)
  • Methotrexate
  • Statins

Symptoms

Exams 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.

Outlook (Prognosis)

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

Possible Complications

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

When to Contact a Medical Professional

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.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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