Recent developments concerning drug-induced liver toxicity

A timely topic: Liver toxicity remains 2 common problem despite adequate in formation for physicians and drug watch programs. The number of recent publ ications reporting severe drug-induced liver disease emphasizes the need fo r prudence. Acute and chronic hepatotoxicity: Cases of acute drug-induced liver disease have been described for nearly all drug classes: a few examples concern he patitis subsequent to administration of fluoxetin, acarbose, riluzole, coum arin, or orlistat. Fulminant hepatitis is fortunately an exceptional event but has been described after administration of ketoprofene, nimesulid, and clarithyromycin. Chronic liver disease has also resulted from the use of me salazine, minocyclin or fibrates. Nevirapin prescribed for HIV infection ca n cause severe liver disease. Other agents: Certain herbal agents, such as chelidoin for example, can cau se cholestasis. Certain excipients can also be toxic for the liver. Ecstasy appears to be a frequent cause of sometimes severe liver disease in younge r subjects.