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Drug-Induced Hepatotoxicity: Abrupt Onset, Idiosyncrasies Limit Options


While medical science has generated much information about the nature and causes of hepatotoxicity secondary to medications or herbal agents, clinicians have few viable options when it comes to preventing these events in their patients. Monitoring of aminotransferase levels during the first 6 months of therapy with known hepatotoxins is prudent, but most drug reactions have an abrupt onset that is rarely detected through such periodic but infrequent tests. Deaths could often be avoided if the offending agent is recognized and discontinued at the first sign of hepatotoxicity.


Lee WM. Drug-induced hepatotoxicity. N Engl J Med. 2003;349:474–85.