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 drugs 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.

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 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 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 nicotinic acid

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

chlorpromazine/valproic imipramine thiabendazole

acid (combination) phenothiazines tolbutamide

chlorpropamide/erythro- phenytoin

mycin (combination)

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/cyclosporine (combination) oral contraceptives

SOURCE: The Essential Guide to Prescription Drugs, 1994 Edition, by James W.

Long and James J. Rybacki. ISBN 0-06-273211-0