echemi logo
Product
  • Product
  • Supplier
  • Inquiry
    Home > Active Ingredient News > Digestive System Information > Which drugs can cause drug-induced liver damage?

    Which drugs can cause drug-induced liver damage?

    • Last Update: 2021-04-14
    • Source: Internet
    • Author: User
    Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com
    It is only for medical professionals to read and take these medicines frequently.
    Pay attention to your "liver".
    On February 9, 2021, the State Food and Drug Administration issued an announcement on the revision of the instructions for methimazole preparations.
    The precautions mentioned that patients are advised to treat In the first 3 months of the initial stage, liver function tests should be done once a month.

    Liver damage usually occurs within 12 weeks after the start of treatment.
    Patients should be reminded to see a doctor immediately if they develop symptoms such as anorexia, nausea, upper abdominal pain, yellow urine, yellowish skin or sclera.

    According to statistics, related drugs that induce liver injury are more common in non-steroidal anti-inflammatory drugs, cardiovascular drugs, anti-tuberculosis drugs, antipsychotics, antibiotics, and anti-tumor drugs.

    In the long-term application of the following high-risk drugs, regular monitoring of liver function is required.

    01.
    Non-steroidal anti-inflammatory drugs The U.
    S.
    Food and Drug Administration (FDA) Arthritis Advisory Committee pointed out that “hepatotoxicity is a characteristic of NSAIDs” and pointed out that non-steroidal anti-inflammatory drugs (NSAIDs) can make 1 %-10% of users have mild liver damage.

    Most of the liver damage caused by NSAIDs is mainly hepatocellular damage, and some can cause cholestasis.

    Table 1 Clinical manifestations of liver damage caused by non-steroidal anti-inflammatory drugs 02.
    Drugs for the treatment of cardiovascular diseases Table 2 Clinical manifestations of liver damage caused by drugs for the treatment of cardiovascular diseases 03.
    Anti-tuberculosis drugs Most of the anti-tuberculosis drugs cause liver damage.
    Such as rifampicin, isoniazid, ethambutol and pyrazinamide all have potential liver toxicity.

    The combined use of isoniazid and rifampicin can increase the risk of liver toxicity.
    Liver function should be closely followed during the course of treatment.

    Discontinuation indications: (1) ALT>3ULN, nausea and other symptoms; (2) ALT>5ULN when asymptomatic; (3) BIL>1.
    5ULN and ALT>3ULN or prothrombin time>1.
    5ULN.04.
    Patients with antipsychotic drugs use antipsychotic drugs for long periods, large doses, and more common combination medications, so they are prone to have varying degrees of toxic effects on the liver.

    Table 3 Clinical manifestations of liver damage caused by antipsychotics 05.
    Antiepileptic drugs commonly used antiepileptic drugs that can cause liver damage include valproic acid, phenytoin and carbamazepine, all of which can cause elevated transaminases to varying degrees, and treatment begins And the liver function needs to be monitored during treatment.

    06.
    Imidazole antifungal drugs, triazoles, are currently the first-line drugs for the treatment of deep fungal infections.
    The representative drugs fluconazole, itraconazole and voriconazole are excreted by bile, and the main toxicity is liver toxicity.

    Table 4 Clinical manifestations of liver damage caused by imidazole antifungal drugs 07.
    Antibacterial drugs Such drugs such as macrolide drugs, sulfa drugs, chloramphenicol, oxacillin, tetracycline, etc.
    can cause significant liver damage.

    08.
    Anti-tumor drugs At present, liver damage caused by anti-tumor drugs has accounted for 1/5 to 1/4 of DILI, which is called the second inducement after Chinese medicine.

    Common anti-tumor drugs that cause liver damage include alkylating agents, antimetabolites, anthracyclines and anthracycline-like drugs, and microvascular drugs.

    Table 5 Clinical manifestations of liver injury caused by anti-tumor drugs At present, we cannot predict drug-induced liver damage.
    Despite the risk of liver damage, it is also a helpless option for some patients, such as anti-tuberculosis treatment.
    You can take liver protection medicine at the same time.

    When using these drugs with liver damage, you must strictly follow the doctor's prescription and perform liver tests on a regular basis, so as to minimize the risk.

     References: [1] Sun Bo, Li Xiaoyu, Liu Gaolin.
    Research progress on drug-induced liver injury related to non-steroidal anti-inflammatory drugs[J].
    World Chinese Journal of Digestion,2015,23(19):3053-3059.
    [2 ]Wu Fei,Wang Xingqiao,Xu Yuancui,Wan Zhongxian,Zheng Liangdong.
    A case of drug-induced liver injury and death caused by voriconazole[J].
    Chinese Pharmacist,2020,23(03):507-509.
    [3]Zhang Lina,Guo Weidong .
    Liver damage caused by antitumor drugs[J].
    World Latest Medical Information Abstracts,2016,16(39):29-30+40.
    [4]Zhao Quanfeng,Fu Peishu,Ma Huan,Zhao Suyu,Guo Daihong,Tang Min.
    Voriconazole Active monitoring of liver damage caused by [J].
    Chinese Journal of Clinical Pharmacology and Therapeutics,2019,24(01):43-48.
    [5]Wang Xiaoliang,Huang Jingjing,Wang Biao,Li Huafang.
    Caused by atypical antipsychotics Research progress of liver damage[J].
    Journal of Psychiatry,2014,27(06):473-477.
    This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.

    Contact Us

    The source of this page with content of products and services is from Internet, which doesn't represent ECHEMI's opinion. If you have any queries, please write to service@echemi.com. It will be replied within 5 days.

    Moreover, if you find any instances of plagiarism from the page, please send email to service@echemi.com with relevant evidence.