Reviewed By: Pramod Kerkar, MD, FFARCSI

Gilbert syndrome is a common harmless inherited disease, which is characterized by periods of elevated bilirubin in the blood. This disease is a genetic disorder caused by the mutation in the liver enzyme named glucuronyl transferase. Thus, due to mutation, this enzyme becomes deficient in the body and Liver does not function properly.

Jaundice comes and goes periodically in episodes. The liver is unable to filter all the toxins from the body especially after starvation, certain medications, alcohol consumption and dehydration.

What Drugs To Avoid If You Have Gilbert Syndrome?

Gilbert syndrome is a hereditary disease that is characterized by a slight elevation in the levels of bilirubin in the blood caused by a mutation in a liver enzyme called glucuronyl transferase. Thus, the liver cannot detoxify certain unwanted chemicals from the body due to deficiency of this enzyme. It affects males more than females. It represents jaundice which is marked by yellowish discoloration of the skin, nails, and eyes. In this, the liver is incapable to perform its functions properly. This disease comes and goes by itself with no requirement of treatment.

Gilbert syndrome also comes under constitutional hepatic dysfunction and familial nonhemolytic jaundice. The abnormal function of liver enzyme namely glucuronyl transferase leads to the slight increase in the levels of bilirubin in the blood especially after consumption of alcohol, starvation or dehydration. The disorder has the episodic occurrence of mild jaundice, particularly in eyes. The other symptoms of the disorder are-

One in three people with Gilbert syndrome does not feel any symptom of the disease. Gilbert syndrome is usually diagnosed at the teenage after puberty. Any specific alterations in the diet are not necessary for people with Gilbert Syndrome. Although treatment is not required for Gilbert syndrome, still patient feel jaundice for long, medical help must be opted to check other causes of jaundice.

In Gilbert syndrome, there is a constant risk of side effects of certain drugs as the enzyme glucuronyl transferase get mutated and it is known to remove these drugs from the body. The drugs that are metabolized by glucuronidation in the liver show increased levels of toxicity in the people with Gilbert's syndrome.

The Drugs That Should Be Avoided In Gilbert Syndrome Are-

Irinotecan – this drug is prescribed for the treatment of advanced bowel cancer. Deficient liver enzyme overloads the liver with toxicity.

Atazanavir and Indinavir- physicians use them to treat infections caused by the HIV virus.

Statins- these are used to control cholesterol levels when consumed with gemfibrozil

Gemfibrozil – drugs usually prescribed for reducing cholesterol

Nilotinib- it is used for the treatment of blood cancers.

Acetaminophen – it can cause further damage to the liver in Gilbert Syndrome.

Antibiotic, Penicillin- someone allergic to penicillin may show liver damage in GS.

Paracetamol- Gilbert syndrome shows the greatest toxicity of paracetamol after an overdose.

Nutritional Supplements- any nutritional supplement that has the high concentration of Vitamin A, niacin, vitamin D or cod or halibut liver oil over recommended dose must be avoided as they cannot be completely metabolized by the liver.

Birth Control Pills- birth control pills are more likely to be processed by the enzyme glucuronyl transferase. Since this enzyme is deficient in GS, bilirubin levels get elevated in the blood by birth control pills.

Conclusion

Gilbert syndrome is an inherited disease that leads to a slight rise in the bilirubin levels in the blood showing mild jaundice symptoms mainly in the eyes. Liver enzyme glucuronyl transferase whose main role is to detoxify certain drugs is deficient in Gilbert syndrome. Physicians do not recommend drugs discussed above to avoid excess stress on the liver and flares of jaundice in people with Gilbert Syndrome.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: July 27, 2018

This article does not provide medical advice. See disclaimer

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