Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a heterogeneous group of medications intended to treat a variety of inflammatory diseases. While they are generally regarded as safe and most known for their potential gastrointestinal and renal side effects, cases of hepatotoxicity have been reported. This review summarizes the US and international literature regarding the incidence of NSAID-induced DILI and the biochemical signature of specific NSAIDs. Multiple studies have identified diclofenac as one of the more common culprits of NSAID-induced DILI. A genetic predisposition to DILI has been identified with diclofenac and lumiracoxib. While NSAID-induced hepatotoxicity is rare, the potential for serious hepatotoxicity exists especially with certain agents such as diclofenac. An improved understanding of pharmacogenomics and post-marketing surveillance/monitoring is needed to reduce the risk of this DILI.

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