Hepatic Failure/GI/Endocrine Emergencies
Appendix 1. Most Common or Well-Described Drugs Associated with DILI and the Patterns of Liver Injury
Drug Class
Typical Pattern of Injury
Antibiotics
β’β Amoxicillin/clavulanate
β’β Isoniazid
β’β Trimethoprim/sulfamethoxazole
β’β Fluoroquinolones
β’β Macrolides
β’β Nitrofurantoin
β’β Minocycline
β’β Cholestatic injury
β’β Hepatocellular injury
β’β Cholestatic injury, can also be hepatocellular injury
β’β Hepatocellular, cholestatic, or mixed injury
β’β Hepatocellular injury
β’β Hepatocellular injury
β’β Hepatocellular injury
Antiepileptics
β’β Phenytoin
β’β Carbamazepine
β’β Lamotrigine
β’β Valproate
β’β Hepatocellular, cholestatic, or mixed injury
β’β Hepatocellular, cholestatic, or mixed injury
β’β Hepatocellular injury
β’β Hepatocellular injury, may also cause hyperammonemia
Nonsteroidal anti-inflammatory drugs
β’β Hepatocellular
Immune modulators
β’β Interferon
β’β Anti-TNF agents
β’β Azathioprine
β’β Hepatocellular injury
β’β Hepatocellular injury
β’β Cholestatic injury, can also be hepatocellular injury
Herbal medications and dietary supplements
β’β Green tea extract
β’β Flavocoxid
β’β Hepatocellular injury
β’β Hepatocellular, cholestatic, or mixed injury
Miscellaneous
β’β Methotrexate
β’β Allopurinol
β’β Amiodarone
β’β Androgen-containing steroids
β’β Inhaled anesthetics
β’β Niacin (more common with long-acting form)
β’β Sulfasalazine
β’β Proton pump inhibitors
β’β Fatty liver
β’β Hepatocellular or mixed injury
β’β Hepatocellular, cholestatic, or mixed injury
β’β Cholestatic injury
β’β Hepatocellular injury
β’β Hepatocellular injury
β’β Hepatocellular, cholestatic, or mixed injury
β’β Hepatocellular injury
TNF = tumor necrosis factor.
Information from: Chalasani NP, Hayashi PH, Bonkovsky HL, et al. ACG clinical guideline: the diagnosis and management of idiosyncratic drug-induced liver injury.