Assessment of drug-induced hepatotoxicity in clinical practice: A challenge for gastroenterologists

Table 1 Medications, herbal products and illicit drugs related to the hepatocellular-type of damage

Compound	Other injury	Comments
Acarbose		FHF
Allopurinol	Granuloma	Hypersensitivity
Amiodarone	Phospholipidosis, cirrhosis
Amoxicillin, Ampicillin
Anti-HIV: (Didanosine, Zidovudine, protease inhibitors)
NSAIDs (AAS, Ibuprofen, Diclofenac, Piroxicam, Indometacin)		Nimesulide; withdrawn
Asparaginase	Steatosis
Bentazepam	Chronic hepatitis
Chlormethizole	Cholestatic hepatitis	FHF
Cocaine, Ecstasy and amphetamine derivatives		FHF
Diphenytoin		Hypersensitivity
Disulfiram		FHF
Ebrotidine	Cirrhosis	FHF
Fluoxetine, Paroxetine	Chronic hepatitis
Flutamide		FHF
Halothane
Hypolipemics; Lovastatin, Pravastatin, Simvastatin, Atorvastatin
Isoniazid	Granuloma, chronic hepatitis	FHF
Ketoconazole, Mebendazole, Albendazole, Pentamidine		FHF
Mesalazine	Chronic hepatitis	Autoimmune features
Methotrexate	Steatosis, fibrosis, cirrhosis
Minocycline	Chronic hepatitis, steatosis	Autoimmune features
Nitrofurantoin	Chronic hepatitis
Nefazodone		FHF, withdrawn
Omeprazole
Penicillin G	Prolonged cholestasis
Pyrazinamide
Herbal remedies		FHF
Germander (Teucrium chamaedrys), senna
Pennyroyal oil, kava-kava
Camellia sinnensis (green tea); Chinese herbal medicines
Risperidone
Ritodrine
Sulfasalazine		Hypersensitivity
Telithromycin
Terbinafine	Cholestatic hepatitis	FHF
Tetracycline	Micro-steatosis	FHF
Tolcapone		FHF, withdrawn
Topiramate
Trazodone	Chronic hepatitis
Trovafloxacin		FHF, withdrawn in Europe
Valproic acid	Micro-steatosis
Venlafaxine
Verapamil	Granuloma
Vitamin A	Fibrosis, cirrhosis
Ximelagatran		FHF, discontinued

Features of hypersensitivity include fever, rash and eosinophilia; FHF: Fulminant hepatic failure.