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
