What is drug-induced liver injury?
In some occasions, the use of some drugs can cause an asymptomatic elevation of the concentration of liver enzymes. This is because, as part of its functions, the liver helps the body to break down certain drugs. However, in some people the process of drug breakdown is slower, a fact that makes that person prone to liver injury or damage.
Prognosis of drug-induced liver injury
Normally, and in most cases, liver damage caused by taking a drug usually disappears after a few weeks simply by stopping the drug that caused the injury. This happens when the cause of the liver problem is identified early.
In some cases, the patient may develop hepatocellular jaundice, which compromises liver function and may even require liver transplantation.
Symptoms of drug-induced liver injury
Drug-induced liver damage can cause a variety of symptoms. The sooner the problem is identified as such, the sooner treatment can be started. These symptoms can be very general or more severe. Some of the common symptoms of liver injury caused by taking drugs may be:
- Abdominal pain
- Diarrhea
- Jaundice
- Hepatomegaly
- Confusion and disorientation
- Fever
- Headache
- Nausea and vomiting
- Lack of appetite
- Dark, cloudy urine
- Feeling of tiredness and fatigue
- Appearance of rashes
- Stools become clay-like or whitish
Some drugs may cause liver damage
Medical tests for drug-induced liver injury
In order to identify and diagnose liver damage caused by the use of a particular drug, the specialist will usually perform a complete medical evaluation as well as a hepatography.
Obviously, if a particular drug is suspected to be causing the problem, the specialist will immediately discontinue treatment.
Once treatment with the problem-causing drug has been stopped, the tests are re-performed, as a decrease in liver enzymes diagnoses the damage introduced or caused by the drugs.
It is worth mentioning that, sometimes, it is very complicated to diagnose that a drug is causing liver damage, since sometimes drugs can cause liver damage even after the medication is finished, even after taking low doses. Thus, sometimes identifying the drug causing the problems is difficult or practically impossible.
What are the causes?
There are certain medications that, for some reason, cause the liver to encounter certain problems when trying to break them down, slowing it down and making the person prone to liver damage.
Some medications can cause liver problems with small doses, even if taken for a short period of time and even if the liver’s breakdown system is functioning normally.
Analgesics and antipyretics containing paracetamol are one of the main causes of liver damage, especially when taken in large doses. People with an alcoholism problem or habitual alcohol consumers are more likely to have this problem.
Some medications that can cause liver damage include the following:
- Steroids
- Birth control pills
- Amiodarone
- Chlorpromazione
- Halothane
- Methyldopa
- Methotrexate
- Statins
- Sulfonamides
- Tetracyclines
- Antiepileptics
Can drug-induced injury be prevented?
There are some ways to try to prevent drug-induced liver injury. Some tips are:
- Do not take too much medication. Only the recommended dosage.
- In the case that a particular medication is prescribed, consisting of paracetamol, and the patient is aware that he/she drinks alcohol in excess, do not take them.
- Always inform the medical specialist of the medications and drugs that the patient is taking.
In turn, there are a number of risk factors that make a person prone to suffer this injury:
- Obesity
- Age, the person is over 18 years old
- The patient constantly consumes alcohol
- Pregnancy
Treatments for drug-induced liver injury
Usually, treatment of these injuries in cases where it is identified early is simply to remove the drug causing the problems- In most cases, the patient will improve on their own a few days after removing the drug that previously caused the problems.
Administering an antidote if available usually ends the problems.
However, there are cases in which the problem is not identified as quickly and may even lead to liver failure.
If the injury is very severe, a liver transplant may be necessary.
Which specialist treats it?
The specialist in Hepatology is in charge of studying, diagnosing and treating liver problems. In cases of drug-induced injury problems, the Internal Medicine specialist and the General Surgeon -in case a liver transplant is necessary- may collaborate in an interdisciplinary manner.