Drug-Induced Hepatotoxicity: A Review

Abstract

Liver is the principle organ for maintaining the body’s internal environment. There is currently no way to reimburse for the absence of liver function. Its major influence is on the flow of nutrients and controls the metabolism of carbohydrate, protein and fats. Drugs are an important cause of liver injury. More than 900 drugs, toxins, and herbs have been reported to cause liver injury. Approximately 75% of the idiosyncratic drug reactions result in liver transplantation or death. Various types of drug induced liver diseases are acute-dose dependent liver damage, acute fatty infiltration, cholestatic jaundice, liver granulomas, active chronic hepatitis, liver cirrhosis, liver tumors etc. In the United States, approximately 2000 cases of acute liver failure occur annually and drugs account for over 50% of them (37% are due to acetaminophen, 13% are idiosyncratic reactions due to other medications). Drugs account for 25% of cases of patients hospitalized with jaundice and approximately 10% of all cases of acute hepatitis. Chronic liver disease and cirrhosis account for some 2% of mean in 17 countries with nearly 40,000 deaths per year. Considering the importance of drug-induced hepatotoxicity as a major cause of liver damage, this review throws light on various drugs which induce hepatotoxicity, with their mechanism of liver damage and clinical scenario.