Table 3.

RUCAM (Roussel Uclaf Causality Assessment Method) scoring for assessing the probable casual relationship

S no	Category	Sub-category	Score
1	Time of onset from beginning the drug	(>90 days)	+1
2	The course of ALT after cessation of the drug	>50% reduction in 8 days	NA
3	Risk factors	Age >55 years	+1
4	Concomitant drug	None	0
5	Search for an alternative cause	All 7 causes of the group-I ruled out (HAV, HCV, HEV, alcoholism-AST/ALT level, sonography, Doppler of hepatic vessels and a recent episode of hypotension. All 5 causes of the group-II ruled out (VZV, CMV, EBV, HSV< and underlying precipitating condition)	+2
6	Previous hepatotoxicity to the same drug	Unknown	0
7	Response to unintentional re-exposure	None	0
	Total score	1–2=unlikely 3–5=possible 6–8=probable 9 or more=highly probable	+4 (3–5=possible cause)

ALT, alanine transaminase; AST, aspartate transaminase; CMV, cytomegalovirus; EBV, Epstein-Barr virus; HAV, hepatitis A virus; HBV, hepatitis B virus; HCV, hepatitis C virus;HEV, hepatitis E virus; HSV, herpes simplex virus; VZV, varicella-zoster virus.