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DRUGS THAT MAY CAUSE LIVER DYSFUNCTION OR DAMAGE

The liver is the principal organ that is capable of converting drugs into forms that can be readily eliminated from the body. Given the diversity in use today and the complex burden they impose upon the liver, it is not surprising that a broad spectrum of adverse drug's effects on liver functions and structures has been documented. The reactions range from mild and transient changes in the results of liver function tests to complete liver failure with death of the host. Many drugs may affect the liver adversely in more than one way, as cited below in several listings. The use of the following drugs requires careful monitoring of their effects on the liver during the entire course of treatment.

This list is just a general guideline. Many drugs affect the liver to one degree or another and we can't list all of them here; new drugs are always being approved for general use. Read the accompanying literature with your prescriptions and always consult with your doctor or pharmacist about any new medication if you have liver disease!

Drugs that may cause ACUTE DOSE-DEPENDENT LIVER DAMAGE
(resembling acute viral hepatitis)

  • acetaminophen
  • salicylates (doses over 2 grams daily)

Drugs that may cause ACUTE DOSE-INDEPENDENT LIVER DAMAGE
(resembling acute viral hepatitis)

  • acebutolol
  • indomethacin
  • phenylbutazone
  • allopurinol
  • isoniazid
  • phenytoin
  • atenolol
  • ketoconazole
  • piroxicam
  • carbamazepine
  • labetalol
  • probenecid
  • cimetidine
  • maprotiline
  • pyrazinamide
  • dantrolene
  • metoprolol
  • quinidine
  • diclofenac
  • mianserin
  • quinine
  • diltiazem
  • naproxen
  • ranitidine
  • enflurane
  • para-aminosalicylic acid
  • sulfonamides
  • ethambutol
  • penicillins
  • sulindac
  • ethionamide
  • phenelzine
  • tricyclic antidepressants
  • halothane
  • phenindione
  • valproic acid
  • ibuprofen
  • phenobarbital
  • verapamil
  • Drugs that may cause ACUTE FATTY INFILTRATION OF THE LIVER

  • adrenocortical steroids
  • phenothiazines
  • sulfonamides
  • antithyroid drugs
  • phenytoin
  • tetracyclines
  • isoniazid
  • salicylates
  • valproic acid
  • methotrexate
  • Drugs that may cause CHOLESTATIC JAUNDICE

  • actinomycin D
  • chlorpropamide
  • erythromycin
  • amoxicillin/clavulanate
  • cloxacillin flecainide
  • azathioprine
  • cyclophosphamide
  • flurazepam
  • captopril
  • cyclosporine
  • flutamide
  • carbamazepine
  • danazol
  • glyburide
  • carbimazole
  • diazepam
  • gold
  • cephalosporins
  • disopyramide
  • griseofulvin
  • chlordiazepoxide
  • enalapril
  • enalapril
  • haloperidol
  • ketoconazole
  • norethandrolone
  • sulfonamides
  • mercaptopurine
  • oral contraceptives
  • tamoxifen
  • methyltestosterone
  • oxacillin
  • thiabendazole
  • nifedipine
  • penicillamine
  • tolbutamide
  • nitrofurantoin
  • phenothiazines
  • tricyclic antidepressants
  • nonsteroidal
  • phenytoin troleandomycin
  • anti-inflammatory drugs
  • propoxyphene
  • verapamil
  • Drugs that may cause LIVER GRANULOMAS (chronic inflammatory nodules)

  • allopurinol
  • gold
  • phenytoin
  • aspirin
  • hydralazine
  • procainamide
  • carbamazepine
  • isoniazid
  • quinidine
  • chlorpromazine
  • isoniazid
  • quinidine
  • chlorpromazine
  • nitrofurantoin
  • sulfonamides
  • diltiazem
  • penicillin
  • tolbutamide
  • disopyramide
  • phenylbutazone
  • Drugs that may cause CHRONIC LIVER DISEASE

    Drugs that may cause active chronic hepatitis

    • acetaminophen (chronic use, large doses)
    • dantrolene
    • methyldopa
    • isoniazid
    • nitrofurantoin

    Drugs that may cause liver cirrhosis or fibrosis (scarring)

    • methotrexate
    • terbinafine HCI (Lamisil, Sporanox)
    • nicotinic acid

    Drugs that may cause chronic cholestasis (resembling primary biliary cirrhosis)

    • chlorpromazine/valproic acid (combination)
    • imipramine
    • thiabendazole
    • phenothiazines
    • tolbutamide
    • chlorpropamide/erythro-mycin (combination)
    • phenytoin

    Drugs that may cause LIVER TUMORS (benign and malignant)

    • anabolic steroids
    • oral contraceptives
    • thorotrast
    • danazol
    • testosterone

    Drugs that may cause DAMAGE TO LIVER BLOOD VESSELS

    • adriamycin
    • dacarbazine
    • thioquanine
    • anabolic steroids
    • mercaptopurine
    • vincristine
    • azathioprine
    • methotrexate
    • vitamin A (excessive doses)
    • carmustine
    • mitomycin
    • cyclophosphamide/cyclo-sporine (combination)
    • oral contraceptives

    SOURCE