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. 2009 May 15:208–246. doi: 10.1016/B0-72-168903-5/50014-8

TABLE 9-6.

Drugs That Have Been Documented or Suspected to Cause Increased Alanine Aminotransferase (ALT) Levels Due to Hepatic Disease

  • Acetaminophen (important) especially cats

  • Amiodarone

  • L-Asparaginase

  • Azathioprine

  • Barbiturates (important)

  • Carprofen

  • Doxycycline

  • Diazepam

  • Erythromycin estolate

  • Glucocorticoids (dogs only) (important)

  • Griseofulvin

  • Halothane

  • Ibuprofen

  • Itraconazole

  • Ketoconazole

  • Mebendazole

  • 6-Mercaptopurine

  • Methimazole

  • Methotrexate

  • Methoxyflurane

  • Nitrofurantoin

  • Oxacillin

  • Oxibendazole

  • Phenobarbital (important)

  • Phenylbutazone

  • Phenytoin

  • Primidone (important)

  • Quinidine

  • Salicylate

  • Salicylazosulfapyridine

  • Sulfonamides

  • Tetracycline

  • Thiacetarsemide (important)

  • Trimethoprim-sulfa drug (important)

NOTE: These drugs do not reliably cause hepatic disease. In a patient with an increased ALT that is receiving one of these drugs, the medication probably should be stopped, if possible, and the ALT rechecked 2 to 4 weeks later. Those drugs that most reliably increase ALT are marked (important). The other drugs are less consistent but may still cause severe hepatic disease. Almost any drug could cause an increased ALT in a particular patient.