Genetic factors — Genetic differences can result in abnormal reactions to drugs, including idiosyncratic reactions. Comorbidities — AIDS patients, those who are malnourished or fasting, may be susceptible to drug reactions because of low glutathione stores.
Drug formulation — Long-acting drugs may cause more injury than shorter-acting drugs. Host factors — in addition to the above, factors that may enhance the risk of liver disease include:. Liver disease and liver disorder can quickly change from nagging pain to quite dangerous.
If you are concerned about any symptoms you have been experiencing, or if you have questions about your digestive health we would be happy to help. Contact Austin Gastroenterology at to set up an appointment at an office near you. Austin Gastroenterology in Central Texas is the largest physician group that specializes in the diagnosis, treatment, and prevention of gastrointestinal diseases. Austin Gastro has more than 30 board-certified gastroenterologists and more than two dozen mid-level providers.
Locations Providers. Drugs and Liver Disorders The state of health of the liver and particular drugs dictate and change the effect on the body.
This depends on: Amount of drug absorption. Speed of drug metabolism into an active or inactive form. If metabolized too quickly drugs may be broken down and eliminated before they can take effect. In slower drug metabolism , side effects are more likely due to longer exposure. Amount of drug distributed throughout the body. Rate of elimination from the body. Sensitivity of the body to the drug. This is very important if you have liver disease.
Talk to your provider about other medicines you may need to avoid. Your provider can tell you which medicines are safe for you. ACG Clinical Guideline: the diagnosis and management of idiosyncratic drug-induced liver injury. Am J Gastroenterol. Liver disease caused by drugs. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. Philadelphia, PA: Elsevier; chap Drug-induced liver injury. Zakim and Boyer's Hepatology.
Gill RM, Kakar S. Liver and gallbladder. Robbins and Cotran Pathologic Basis of Disease. Updated by: Michael M. Editorial team. Other types of liver injury include: Viral hepatitis Alcoholic hepatitis Autoimmune hepatitis Iron overload Fatty liver. Many different drugs can cause drug-induced hepatitis. In addition, even healthy persons should avoid taking 3,mg of acetaminophen daily for more than 3 to 5 days. Patients with liver disease should restrict the daily amount of acetaminophen to 2,mg per day, or even less if severe liver disease is present.
Even if you have no liver disease, always use the smallest amount of acetaminophen needed to obtain relief. It is important that you read the labels of all prescription and non-prescription medications that you take. Often acetaminophen may be present in several medications which could cause you to take a dose of acetaminophen that exceeds the safe limits.
People who drink alcoholic beverages regularly are at higher risk of developing severe liver damage from acetaminophen. Drinking alcohol regularly changes the way the liver breaks down certain medications. In the case of acetaminophen, alcohol use leads to accumulation in the liver of a toxic byproduct of acetaminophen that can kill the liver cells.
People who drink alcohol regularly should not take acetaminophen or take it in small doses if at all. These medications have been used in millions of people with an excellent safety record and very little evidence of liver damage, even when used in people with mild liver disease. It is not rare, however, for people to develop minor elevations of the liver tests soon after they start taking these medications.
In the vast majority of cases, these elevations are less than 3 times the baseline level and the levels return to normal despite continued use of the medication; recently the FDA discontinued the recommendation for routine monitoring of liver tests when starting a patient on statins. If the liver tests are monitored, the medication should not be stopped if only minor elevations of liver tests are noted.
The production and distribution of these supplements is not regulated as carefully as the production of prescription medications. Sometimes the herb or supplement itself can cause liver damage. In other cases, impurities or toxins introduced during the preparation of the product may be toxic to the liver. Some of the natural products known to be toxic to the liver include chaparral, comfrey tea, kava, skullcap, and yohimbe, but there are many others.
Even vitamin supplements and dietary supplements, such as weight losing products, can be harmful. Too much iron or vitamin A can result in significant liver damage. Generally speaking, you do not need to take iron supplements unless you have been diagnosed with iron deficiency. Vitamin A dose should never exceed 5, units a day, unless provided as beta-carotene. With very rare exceptions, people that have mild liver disease can safely take most common prescription and non-prescription medications at the recommended dose.
Having mild liver disease such as hepatitis C or fatty liver does not increase the risk that a given medication will be toxic to the liver, however, if a person with pre-existing liver disease happens to develop liver injury from a medication, the resulting liver damage may be more severe than would occur in an otherwise healthy person with the same reaction.
Often physicians may be reluctant to start patients on a cholesterol lowering medication if the liver tests are already mildly elevated; usually due to fatty liver disease. Research has shown that cholesterol lowering medications are safe in people with fatty liver disease or mild hepatitis C infection, and in fact, may be beneficial to the liver by decreasing inflammation.
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