List of drugs that can damage the liver if taken not according to regulations

Any medicine you take will pass through the liver to be broken down first before being used by the body. The remaining unused medicinal chemicals are then removed by the liver so that they do not accumulate into toxins in the body. This process is usually efficient and without causing harm. After all, the medical drugs on the market have passed rigorous medical tests beforehand to ensure that their effects will not damage the liver. But if it is not consumed according to the rules of use, then the drug can cause liver damage. What types of drugs can damage the liver?

Various types of drugs that damage the liver

Many drugs can affect liver function, damage it, or do both. Some medications can even cause direct damage to the liver and cause symptoms such as jaundice, stomach pain, itching, and a tendency to be more prone to bruising and bleeding. In some cases, drug-induced liver damage may have no symptoms at all, so the damage can progress without being noticed.

Here are a number of drugs that damage the liver.

1. Acetaminophen (Paracetamol)

Acetaminophen (paracetamol) is often found in fever-reducing drugs, flu relievers, as well as over-the-counter pain relievers. Most pain medications labeled as "non-aspirin" contain acetaminophen as the main ingredient.

If used as directed, acetaminophen is very safe even for people with liver disease. However, acetaminophen that is consumed too much at once or consumed in high doses continuously for more than 3-5 days can cause liver damage.

For those of you who are healthy, it is advisable not to take more than 1000 mg of acetaminophen per one drink, or no more than 3000 mg per day - a maximum of 1,000 mg every 8 hours.

2.NSAIDs (Non-Steroid Anti-Inflammatory)

NSAIDs are pain relievers, for example for fever and headaches. NSAIDs are also usually prescribed to treat inflammation of the bones and joints, such as arthritis, tendinitis, and bursitis. The most commonly used types of NSAIDs are aspirin, ibuprofen, naproxen, and diclofenac.

Ibuprofen and other NSAIDs rarely affect the liver, but this complication is more common in people taking diclofenac. Liver damage from diclofenac can occur several weeks to months after you start taking it.

3. Antibiotics

Antibiotics can also be harmful to the liver if not taken properly. Examples are Amoxicillin / clavulanate which is used for bronchitis, sinus, and throat infections, and isoniazid, an antibiotic used to treat tuberculosis.

Liver damage from amoxicillin / clavulanate can occur as soon as you start taking it, although signs of liver damage are often detected too late - even after you stop treatment. While acute liver injury that occurs with isoniazid can appear weeks to months after you start taking it.

This is why you are emphasized not to drink alcohol while taking isoniazid, along with other drugs such as acetaminophen and rifampicin. Examples of other antibiotics that can damage the liver include clindamycin, erythromycin, nitrofurantoin, rifampin, sulfonamide, tetracycline, and trimethoprim / sulfamethoxazole.

4. Methotrexate

Methotrexate is a drug used for the long-term treatment of severe psoriasis, rheumatoid arthritis, psoriatic arthritis, cancer, and some patients with Crohn's disease. Patients who have pre-existing liver disease, obesity, and those who drink alcohol regularly are at increased risk of developing cirrhosis of the liver as a result of methotrexate consumption. Methotrexate is also reported to cause fatty liver.

So, doctors will usually prescribe methotrexate in a low dose once a week. Some doctors also perform liver biopsy in patients without liver symptoms after two years (or after a cumulative dose of 4 grams of methotrexate) to detect early cirrhosis of the liver.

5. Amiodarone

Amiodarone is a drug used to treat irregular heart rhythms (arrhythmias) such as atrial fibrillation and ventricular tachycardia. Amiodarone can cause liver damage ranging from mild and easily reversed liver enzyme abnormalities, fatty liver, to acute liver failure and permanent cirrhosis. This is because large amounts of amiodarone are stored in the liver.

Leftover drugs can cause fatty liver, hepatitis, and more importantly, they can continue to damage the liver even after the drug is stopped. Serious liver damage can lead to acute liver failure, cirrhosis, and the need for a liver transplant. However, serious liver damage occurs in less than 1% of patients.

6. Statins

Statins (atorvastatin, simvastatin, lovastatin, and pravastatin) are drugs to lower "bad" cholesterol (LDL) and prevent heart attacks and strokes. These drugs are less likely to cause significant liver injury, but statins often affect liver function blood tests.

Statins can increase liver enzyme levels, but most doctors believe they are safe for long-term use. This disorder usually gets better or completely resolved when stopping the statin or reducing the dose.

Statins in reasonable doses do not cause permanent damage. However, high doses of statins can cause toxicity to the liver (hepatoxicity) which can cause severe damage, including liver failure leading to liver transplantation.

7.Nicotine acid (Niacin)

Niacin, like statins, is used to treat elevated blood cholesterol levels as well as elevated triglyceride levels. And just like statins, niacin can damage the liver. Niacin can cause increased results on AST and ALT blood tests, jaundice, and in rare cases, niacin can cause liver failure.

Liver poisoning (hepatoxicity) can also occur after taking high doses of niacin - more than 2 grams per day. Patients with pre-existing liver disease and those who drink alcohol regularly have a higher risk for developing liver toxicity.

Sustained-release niacin is also more likely to cause liver toxicity than immediate-release.

8. Anticonvulsant drugs

Some anti-seizure / antiepileptic medicines can cause liver damage. Phenytoin can cause liver damage as soon as you start taking it, which is why your liver tests will be closely monitored. Valproate, phenobarbital, carbamazepine, and lamotrigine can also cause liver injury which may appear a little slower after you take them for weeks or months.

9. Azathioprine

Azathioprine is a drug that controls the immune system. Examples of drug use are for Crohn's disease and autoimmune hepatitis. Liver damage can occur weeks to months after taking azathioprine.

10. Antidepressants

Antidepressants are drugs to treat clinical depression or prevent recurrences. This drug can also be used to treat several other conditions, including dysthymia, anxiety disorders, obsessive compulsive disorder (OCD), eating disorders, chronic pain, neuropathic pain, attention-deficit hyperactivity disorder (ADHD), addiction, snoring, migraines, and menstrual pain (dysmenorrhea).

Some examples of antidepressants that can damage the liver include bupropion, fluoxetine, mirtazapine, paroxetine, sertraline, trazodone, and tricyclic antidepressants such as amitriptyline. Risperidone and quetiapine are both used as antipsychotics and antidepressants. These medications can cause blockage of bile flow from the liver (cholestasis).

11. Other medicines

Other drugs that can damage the liver include birth control pills, anabolic steroids, antifungal drugs (ketoconazole, terbinafine), acarbose (diabetes medication), antiretrovirals (HIV infection drugs), disulfiram (drugs to treat alcoholism), allopurinol (preventative drugs). gout attack) and antihypertensive drugs (captopril, enalapril, irbesartan, lisinopril, losartan, verapamil).

These drugs can damage the liver, among others, can cause liver injury to hepatitis even in moderate doses. It is important that you take your medication exactly as prescribed and do not drink alcohol while taking it.

Herbal supplements and medicines can also damage the liver

Apart from medical drugs, supplements and herbal remedies can also cause liver damage. Moreover, testing for supplements and herbal medicines is usually not as rigorous as testing for medical drugs. Therefore, the potential harm may be even greater to your health.

Herbal medicines that are harmful to the liver include (and are not limited to) borage, comfrey, and certain Chinese herbs, such as zi cao (groomwell), han kuan dong (coltsfoot), qian li guang (liferoot), and pei lan (Eupatorium) contains the alkaloid pyrrolizidine.

The alkaloid pyroglizidine can gradually damage the liver if taken in small doses for a long time. Damage can occur more quickly if large amounts of the drug are consumed. Veins in the liver can become blocked and block the flow of blood out of the liver.

Several other herbal ingredients commonly made in teas, for example including Ma Huang, Kava Kava, germander, and chaparral leaves have been reported to cause liver poisoning (hepatoxicity). Even ginger, which is popularly taken as a herbal medicine, is reported to have blood thinning properties that can cause acute kidney bleeding in people with liver disease.

Excessive consumption of vitamin A over the years can also damage the liver. Liver disease caused by vitamin A includes mild elevations of liver enzymes in blood tests, hepatitis, chronic hepatitis with cirrhosis, to liver failure.

We recommend that you do not take supplements or herbal medicines that have not been proven safe through BPOM clinical trials. Even if proven safe, don't overdo it. Remember, always read the rules of use.

x