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Related Subjects: | Chronic Liver Disease | Liver Function Tests | Drug-induced Liver Injury | Liver Biopsy
Drug-induced liver injury (DILI) varies widely, from minor enzyme changes to acute liver failure. Certain medications pose a higher risk for severe injury or chronic liver disease. Regular monitoring and early identification of adverse hepatic reactions are essential for mitigating severe outcomes.
Side Effect | Associated Drugs | Typical Onset |
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Cholestasis | Chlorpromazine, high-dose oral contraceptives, amoxicillin-clavulanate. | Typically within the first month of therapy, manifesting as jaundice, pruritus. |
Mixed Hepatic/Cholestatic Injury | NSAIDs, Co-Amoxiclav, Statins, Sulfamethoxazole-trimethoprim. | Develops variably; can occur at any stage during treatment. |
Acute Hepatitis | Isoniazid, Rifampicin, Paracetamol (overdose), Methyldopa, Halothane. | Within weeks to months; often marked by ALT and AST elevations. |
Non-Alcoholic Steatohepatitis (NASH) | Amiodarone, Tamoxifen, Tetracyclines, Sodium Valproate. | Occurs over months to years with long-term therapy, leading to fat accumulation in hepatocytes. |
Venous Obstruction (Veno-Occlusive Disease) | Busulfan, Azathioprine, Mercaptopurine, certain chemotherapy agents. | Weeks to months post-treatment initiation, causing hepatic congestion and fibrosis. |
Hepatic Fibrosis | Methotrexate (dose-dependent), certain antiretrovirals, methyldopa. | Develops over years; associated with prolonged use and cumulative dosing. |
Granulomatous Hepatitis | Allopurinol, Quinidine, Sulfonamides, Phenytoin. | Manifests within weeks to months, showing noncaseating granulomas on liver biopsy. |
Identifying and monitoring patients on high-risk medications is essential, especially for drugs with known hepatotoxicity. Early withdrawal of the offending agent can prevent further liver damage.