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
• Amoxicillin/clavulanate
• Isoniazid
• Trimethoprim/sulfamethoxazole
• Fluoroquinolones
• Macrolides
• Nitrofurantoin
• Minocycline
• Cholestatic injury
• Hepatocellular injury
• Cholestatic injury, can also be hepatocellular injury
• Hepatocellular, cholestatic, or mixed injury
• Hepatocellular injury
• Hepatocellular injury
• Hepatocellular injury
Antiepileptics
• Phenytoin
• Carbamazepine
• Lamotrigine
• Valproate
• Hepatocellular, cholestatic, or mixed injury
• Hepatocellular, cholestatic, or mixed injury
• Hepatocellular injury
• Hepatocellular injury, may also cause hyperammonemia
Nonsteroidal anti-inflammatory drugs
• Hepatocellular
Immune modulators
• Interferon
• Anti-TNF agents
• Azathioprine
• Hepatocellular injury
• Hepatocellular injury
• Cholestatic injury, can also be hepatocellular injury
Herbal medications and dietary supplements
• Green tea extract
• Flavocoxid
• Hepatocellular injury
• Hepatocellular, cholestatic, or mixed injury
Miscellaneous
• Methotrexate
• Allopurinol
• Amiodarone
• Androgen-containing steroids
• Inhaled anesthetics
• Niacin (more common with long-acting form)
• Sulfasalazine
• Proton pump inhibitors
• Fatty liver
• Hepatocellular or mixed injury
• Hepatocellular, cholestatic, or mixed injury
• Cholestatic injury
• Hepatocellular injury
• Hepatocellular injury
• Hepatocellular, cholestatic, or mixed injury
• 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.