16th May 2025

Hepatotoxic drugs

Hepatotoxicity is the injury or damage to the liver caused by drug exposure and may be dose related or idiosyncratic. Patterns of idiosyncratic drug induced liver injury include hepatocellular, cholestatic, or mixed. Drug induced liver injury should be considered in acute liver injury or jaundice without any evidence of obstruction. In the presence of impaired liver function those drugs that cause dose-related damage may do so at lower doses, and those that produce idiosyncratic reactions may occur at an increased frequency. These drugs should be avoided or used with caution in patients with liver disease. Examples of hepatotoxic drugs include:

• Co-amoxiclav
• Nitrofurantoin
• Infliximab
• Azathioprine