What Drugs Are Bad For The Liver?

Many drugs can affect the way the liver functions. The liver is the most interesting organ in the human being which performs a various function. One of the major functions of the liver is metabolism; it processes a wide range of drugs resulting in the water-soluble end product which is excreted in the bile. There are numerous drugs sold in the market which can bring a deleterious effect to the liver function. The prolonged use of the medicine may increase the liver enzymes abnormally and can alter the metabolic activity resulting in liver failure. Jaundice, stomach discomfort, burning sensation, and tendency to bruise and bleed are some of the symptoms of drug toxicity.

Clinicians refer to this condition as “drug-induced liver injury”. The term also includes damage caused by toxic herbs or plants and nutritional supplements.

Paracetamol is the most common conventional drug taken in overdose in the western countries. It is toxic to the liver even at low percentage can induce hepatocellular necrosis which can result in fatal liver failure. A 7.5 g of paracetamol can completely alter the pathways of metabolism.

Amoxicillin is a classic example of an antibiotic used for upper respiratory tract complaints such as bronchitis, sinus and throat infections. Liver damage from amoxicillin can happen soon after taking it. The signs of liver injury are often detected even after withdrawal of the medication.

Antibiotics such as clindamycin, erythromycin, nitrofurantoin, rifampin, sulfonamides, tetracyclines, trimethoprim/sulfamethoxazole, isoniazid, and pyrazinamide can induce liver damage if appropriate dose not followed. Isoniazid is a well-known anti-tuberculosis drug, which can cause acute liver injury.

Anticonvulsant medications such as carbamazepine, phenobarbital, phenytoin, and valproate have been incriminated in causing idiosyncratic drug-induced liver disease.

Prolong use of statins can induce muscle pain, digestive problems, mental fuzziness and may rarely cause liver damage. It is used as an anti-cholesterol drug, can increase the levels of liver enzymes and cause liver damage usually minor but no symptoms.

Certain inhalational agents, principally halothane, have been implicated in causing liver hepatitis. There are two types of halothane-induced liver hepatitis. Type 1 which is mild, transient and has a relatively high incidence (25 to 30%). Type 2 caused by oxidative metabolism of halothane in the liver leading to fever, jaundice, and dramatically elevated serum transaminases.

Pain relievers like non-steroidal anti-inflammatory drugs (NSAIDs) can also cause liver injury, example -diclofenac.

Several anti-seizure medications such as dilantin, carbamazepine, and lamotrigine can cause liver damage. Carbamazepine and lamotrigine can induce cause liver injury in patients who have been taking it for weeks or months.

At present, anti-depressants are the most commonly prescribed drugs and also important causes of drug-induced liver injury – Bupropion, fluoxetine, mirtazapine, paroxetine, sertraline, trazodone, and tricyclic antidepressants such as amitriptyline. Risperidone and quetiapine are both used as antipsychotics and antidepressants. These medications can cause a blockage in the flow of bile from the liver.

Other drugs include heart drugs (amiodarone and clopidogrel), cancer drug methotrexate, and antiretroviral therapy drugs (used to treat HIV infection) can cause liver injury.

Some medicinal herbs contain toxic substances that can damage the liver. Herbs contain a high concentration of alkaloids can induce 20% damage to the liver. These include dietary supplements with a high amount of pyrrolizidine alkaloids. This may be seen in some tea extracts, which cause abdominal pain and sometimes vomit. Fluid accumulates in the abdomen and legs and eventually, scar tissue in the liver, liver failure, and even death may result. These herbs include borage, pennyroyal oil, celandine (in the poppy family), Kombucha tea, misteltoe, Sho-saiko-to, yerba tea, comfrey, and certain Chinese herbs, such as zi cao (groomwell), kuan dong hua (coltsfoot), qian li guang (liferoot), and pei lan (Eupatorium).

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