Table 1.
Medications commonly implicated in drug-induced liver injuries
| Type | Drug class | Common medications |
|---|---|---|
| Dose-dependent | Aniline analgesic | Acetaminophen—very common, ≥ 50% of all cases of DILI [3] |
| Inhaled anesthetics | Halothane | |
| Idiosyncratic | Antibiotics and other antimicrobials | Amoxicillin-clavulanate, fluoroquinolones (moxifloxacin, levofloxacin), minocycline, tetracycline, nitrofurantoin, trimethoprim-sulfamethoxazole [2, 4], isoniazid [28], erythromycin [29], clindamycin, nafcillin, dicloxacillin, ampicillin, penicillin, cephalexin, rifampin, dapsone, ketoconazole, terbinafine [30], antiretrovirals [31] (efavirenz, nevirapine [9], zidovudine, stavudine [32], didanosine) |
| Non-steroidal anti-inflammatories (NSAIDs) | Diclofenac, naproxen, acetylsalicylic acid [33], mesalazine, clometacin, sulindac | |
| Antiarrhythmics | Amiodarone [6], quinidine, procainamide | |
| Statins and other lipid-lowering agents | Atorvastatin [34], lovastatin [35], ezetimibe [9], fenofibrate | |
| Antihypertensives | Captopril [9], diltiazem, lisinopril, nifedipine, amlodipine [17], verapamil [24], methyldopa, hydrochlorothiazide, dihydralazine | |
| Antiepileptics, anticonvulsants, anxiolytics | Phenytoin, valproate, bentazepam [34], diazepam, carbamazepine [9], zonisamide | |
| Anti-diabetic agents | Rosiglitazone, troglitazone [9], tolbutamide | |
| Antipsychotics and antidepressants | Chlorpromazine [36], prochlorperazine, haloperidol, amitriptyline, imipramine | |
| Immunosuppressants | Glucocorticoids, methotrexate, azathioprine, cyclophosphamide, mercaptopurine | |
| Chemotherapeutic agents | Cisplatin, oxaliplatin, 5-fluorouracil, floxuridine, tamoxifen | |
| Other notable agents | Propylthiouracil, tacrine, allopurinol, flutamide, estradiol, vitamin A, anabolic steroids, hydroxyurea, danazol, papaverine, dantrolene |
These medications are commonly associated with drug-induced liver injuries. Acetaminophen, amoxicillin-clavulanate, amiodarone, atorvastatin, and captopril account for the vast majority of cases. In particular, acetaminophen, isoniazid, propylthiouracil, phenytoin, valproate, and fluoroquinolones account for the vast majority of drug-induced fulminant liver failures [4, 5]