Patient education: Drug-induced hepatitis (The Basics)

What is drug-induced hepatitis? — Drug-induced hepatitis is a condition that affects the liver. The liver is a big organ in the upper right side of the belly (figure 1).

"Hepatitis" is a general term that means inflammation of the liver. It has different causes. In drug-induced hepatitis, the inflammation is caused by medicines, herbal or diet supplements, or harmful chemicals.

What medicines can cause drug-induced hepatitis? — Both prescription and over-the-counter medicines can cause drug-induced hepatitis. Some common examples are:

●Acetaminophen (sample brand name: Tylenol)

●NSAIDs, which are a large group of medicines that includes ibuprofen (sample names: Advil, Motrin) and naproxen (sample brand name: Aleve)

●Certain antibiotics

Drug-induced hepatitis can happen within days of taking a medicine or supplement. It can also happen after people have been taking a medicine or supplement for months.

For some medicines, like acetaminophen, drug-induced hepatitis happens if people take too much of the medicine. For other medicines, like antibiotics, drug-induced hepatitis happens when people take a normal dose.

What are the symptoms of drug-induced hepatitis? — Some people with drug-induced hepatitis have no symptoms. They find out that they have it after their doctor does routine blood tests or blood tests for another reason. For instance, doctors sometimes do blood tests if people are taking a medicine that has a high chance of causing drug-induced hepatitis.

When drug-induced hepatitis causes symptoms, they can include:

●Belly pain

●Nausea and vomiting

●Not feeling hungry

●Jaundice, which is when the skin or white part of the eye turns yellow

Should I see my doctor or nurse? — Yes. Call your doctor or nurse if you have the symptoms above, especially if you started taking a new medicine or supplement.

Is there a test for drug-induced hepatitis? — Yes. To check for liver inflammation, your doctor or nurse will do blood tests to measure substances called "liver enzymes."

Your doctor or nurse might do other tests to make sure that you don't have another liver condition. These can include:

●An imaging test – Imaging tests create pictures of the inside of the body.

●A liver biopsy – For this test, the doctor uses a needle to remove a small sample of tissue from the liver. Then, another doctor looks at the sample under a microscope.

How is drug-induced hepatitis treated? — The main treatment for drug-induced hepatitis is to avoid the medicine, supplement, or chemical that inflamed your liver.

Most people do not need any other treatment, because their liver will heal on its own. But it can take weeks to months for the liver to heal. During this time, your doctor or nurse will probably do repeat blood tests to check your liver enzymes.

While your liver is healing, your doctor or nurse will also probably recommend that you:

●Avoid drinking alcohol

●Check with them before you take any medicines or supplements

Sometimes, drug-induced hepatitis causes severe liver damage and liver failure. This happens most often when people overdose on acetaminophen. People with liver failure usually need a liver transplant, which is surgery to replace a diseased liver with a healthy liver.

People who get drug-induced hepatitis after taking a medicine or supplement for a long time can sometimes get scarring of the liver, called "cirrhosis." People with severe cirrhosis might also need a liver transplant.

Can drug-induced hepatitis be prevented? — To help prevent drug-induced hepatitis, you can:

●Follow your doctor's instructions when you take prescription medicines.

●Read the Drug Facts label on all over-the-counter medicines that you take (figure 2). This label tells you what the recommended dose is. Do not take more than the recommended dose.

You should also read the Drug Facts label to find out what the medicine's "active ingredient" is. The active ingredient is the part of the medicine that treats symptoms. Medicines that treat different conditions can have the same active ingredient. Do not take 2 medicines with the same active ingredient, because it could cause an overdose. For instance, if you are taking acetaminophen to treat a fever or pain, do not also take a cold medicine with acetaminophen in it.

●Avoid drinking too much alcohol.

More on this topic

Patient education: Acetaminophen poisoning (The Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (The Basics)
Patient education: Side effects from medicines (The Basics)
Patient education: Complementary and alternative medicine (The Basics)
Patient education: Cirrhosis (The Basics)
Patient education: Jaundice in adults (The Basics)
Patient education: Alcohol use — when is drinking a problem? (The Basics)
Patient education: Giving your child over-the-counter medicines (The Basics)

Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (Beyond the Basics)
Patient education: Cirrhosis (Beyond the Basics)
Patient education: Liver biopsy (Beyond the Basics)
Patient education: Alcohol use — when is drinking a problem? (Beyond the Basics)