Drug-induced liver injury

For a lay person:

Drug-induced liver injury is damage to the liver caused by a medicine, supplement or herbal product. It can occur with prescription drugs, over-the-counter painkillers such as paracetamol and some herbs, and ranges from abnormal blood tests to severe liver failure.

For a trained medical person:

Classified as hepatocellular, cholestatic or mixed (R ratio), and as intrinsic dose-dependent injury (for example paracetamol) or idiosyncratic injury; herbal and dietary supplements are a recognised cause. Diagnosis relies on temporal association, exclusion of other causes and causality tools such as RUCAM. Management is stopping the suspected agent, N-acetylcysteine for paracetamol toxicity, and monitoring for liver failure.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Liver Qi Stagnation Type; Damp-Heat with Wind Type; Damp-Heat Type; Stasis in Gallbladder Type. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Stop the suspected medicine or herbal product and seek urgent care for jaundice, confusion, drowsiness, bleeding or bruising. Herbal products can themselves cause this injury; do not take new herbs for liver damage without your doctor's agreement.