19th May 2025

Management

Immediate cessation of the offending therapeutic agent once DILI is suspected is vital. 

In some instances, there is a case for the use of corticosteroid therapy, particularly when an immune-mediated aetiology is suspected or in cases of DILI which demonstrate biopsy features of autoimmune hepatitis. 

Some specific treatment agents for DILI exist depending on the offending drug; among these are N-acetylcysteine for paracetamol overdose and L-carnitine for valproic acid overdose. N-acetylcysteine occasionally also has a role in the treatment of non-paracetamol induced ALF, particularly when identified early in the disease course. 

There is no evidence at present in support of the use of ursodeoxycholic acid in cholestatic DILI with pruritus but its use is common in practice.