Drug-induced hepatitis | Medibuddy
22nd July 2023

Drug-induced hepatitis

Also known as drug-induced liver injury (or DILI), this is an important cause of hepatitis. People with pre-existing liver disease and a history of alcohol excess are at increased risk. DILI is generally categorised by the type of damage caused to the liver, divided into hepatocellular and cholestatic (though the latter group may also cause a mixed picture). The causative drugs are summarised in the table below.

Methotrexate, methyldopa and amiodarone are also associated with a separate risk of liver cirrhosis.

Hepatocellular Cholestatic
Paracetamol
Sodium valproate
Phenytoin
Monoamine oxidase inhibitors
Halothane
Anti-tuberculosis drugs: isoniazid, rifampicin, pyrazinamide
Statins
Alcohol
Amiodarone
Methyldopa
Nitrofurantoin
Combined oral contraceptive pill
Flucloxacillin
Co-amoxiclav
Erythromycin
Anabolic steroids and testosterones
Chlorpromazine and prochlorperazine
Sulphonylureas
Fibrates
Nifedipine (rarely)

Table 3: Categorisation of drug-induced liver injury

Treatment is of cessation of the causative drug, then supportive treatment of any acute symptoms and chronic long-term complications.

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