Medications and the Liver

The liver filters and processes everything that goes into the body, including over-the-counter and prescription medications. During this process, toxins can be produced that inflame and damage the liver. This is known as toxic liver disease, hepatotoxicity, or toxic hepatitis. Over time, this can lead to liver failure or even death.

Medications that can damage the liver

A variety of medications can lead to liver damage. Some of the most common examples include the following:

• Acetaminophen, aspirin, ibuprofen, and naproxen sodium (when taking more than the recommended dose or mixing with alcohol)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Certain antibiotics
• Sulfa-containing drugs
• Certain arthritis medications, such as methotrexate or azathioprine
• Statins
• Steroids
• HIV antivirals
• Allopurinol

Symptoms of drug-induced liver injury

Symptoms of drug-induced liver injury can be mild or severe. They include, but are not limited to, the following:

• Abdominal pain, especially in the upper right portion of the abdomen
• Dark urine
• Fatigue
• Fever
• Jaundice (yellowing of the eyes and skin)
• Nausea or vomiting
• Diarrhea
• Loss of appetite or weight loss
• Itching
• Gray or white stool

Toxic liver disease risk factors

Some people are more susceptible to medication-induced liver damage than others. Factors that increase the risk of developing toxic liver disease include the following:

• Use of multiple over-the-counter pain relievers or taking more than the recommended dose
• Use of over-the-counter pain relievers or other medications with alcohol
• Pre-existing liver disease, such as cirrhosis or fatty liver disease
• Having a gene mutation that affects liver function
• Aging (The liver takes longer to break down substances, so toxins and their byproducts remain in the body longer.)
• Female gender at birth (Females may metabolize some toxins more slowly than males, exposing the liver to higher toxic blood concentrations for longer periods.)
• Working with industrial or commercial toxins

Although certain medications come with a risk of liver damage, they also have various benefits. Weighing the potential risks vs. the benefits — with the help of a physician — is essential.