Prescription Drugs That Affect the Liver

As the body’s chief filtering mechanism, the liver plays a key role in the metabolism of medications. Certain prescription medications can cause liver toxicity, which may lead to liver damage if not treated early.

Significance

• According to medscape.com, drugs are responsible for 20 to 40 percent of all cases of liver failure, making hepatotoxicity the leading cause of drug recall in the United States.

Types

• According to merck.com, prescription medications can affect the liver by causing three basic types of damage: hepatocellular, cholestatic, or mixed hepatotoxicity. Drugs from the statin family (Lipitor and Crestor) and acetaminophen may cause hepatocellular changes, while tricyclic antidepressants (imipramine and clomipramine) and phenytoin are known to cause cholestatic and mixed changes, respectively. The antibiotic, amoxicillin, also has been linked to cholestatic liver damage.

Effects

• Hepatocellular toxicity causes elevated levels of aminotransferase (the enzymes ALT and/or AST) in the liver. In cholestatic toxicity, levels of serum alkaline phosphatase are too high, while patients with mixed hepatotoxicity exhibit characteristics of both cholestatic and hepatocellular damage.

Symptoms

• Depending on the type and extent of damage, liver impairment can cause a host of symptoms, including pain in the upper right abdomen, jaundice, pruritis (itching) and dark urine. Other symptoms, such as appetite loss, fatigue and pale-colored stool, may also be present.

Warning

• If you experience symptoms of liver impairment while taking prescription drugs, seek medical help immediately. It may be necessary to have your liver enzyme levels checked regularly while taking certain medications.