Medications That Can Harm Your Liver

The liver deserves as much attention as the heart, lungs, or kidneys because it is one of the hardest-working organs in the body. This organ has several functions, including purifying the blood, helping with digestion, and detoxifying the body.

Some medications, however, can slow the liver down and even make it sick, a condition known as “drug-induced liver injury,” according to Dr. Udoka Ikezuagu, a hospitalist at Loma Linda University Medical Center in Murrieta, California. Most medications are safe for the liver when taken as directed. However, older adults who take multiple medications increase the risk of stress and damage to their liver.

AARP has identified medications that can harm the liver and provided ways to protect it from damage.

Over The Counter (OTC) Medications

1. Acetaminophen (Tylenol)

Tylenol is a popular OTC acetaminophen for treating mild to moderate pain and reducing fever. Acetaminophen is safe, but you can take too much of it because it is found in cold and flu remedies and other medications. The harm to your liver increases if you drink alcohol or have previous liver issues.

To protect your liver:

2. Talk to your doctor or pharmacist before taking acetaminophen if you drink alcohol or already have liver problems.

2. Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs treat pain, inflammation, and fever. The most familiar NSAIDs are Advil and Motrin (Ibuprofen), Aleve (naproxen), and Voltaire (diclofenac).
NSAIDs are generally safe for short-term use but can put stress on the liver and, in some cases, harm the liver if used for prolonged periods or at higher doses. Individuals are at greater risk for liver damage if they already have liver conditions or use several medications that impact liver function.

To protect your liver, consult your doctor before using NSAIDs. Your doctor may recommend starting with a low dose for a short time or may suggest an alternative.

Prescription Medications

1. Statins

Statins are used to lower cholesterol and protect against heart attack and stroke. Lipitor (atorvastatin), Zocor (simvastatin), and Crestor (rosuvastatin) are among the most familiar statins.

Statins are typically safe but can sometimes elevate liver enzymes. If enzyme levels are elevated three times the upper limit of normal, your doctor may have you stop taking the statin. Enzyme levels will go back to normal once you stop taking the medication. In rare cases, statins can cause serious liver problems, especially if you already have issues with your liver.

Your doctor might order blood tests to monitor your liver function and make any needed adjustments to your dosage.

2. Amoxicillin-clavulanate (Augmentin)

Amoxicillin-clavulanate is an antibiotic that treats various bacterial infections. Amoxicillin-clavulanate can sometimes damage the liver, but the exact cause is not clear. Studies suggest it is likely due to an allergic reaction triggered by clavulanate.

Liver problems may develop a few days to weeks after starting the medication or even after you stop taking it. The risk increases with prolonged use and pre-existing liver conditions.
To protect your liver, watch for jaundice (yellow skin or eyes), fatigue, or dark urine. Contact your doctor immediately if you develop any of these symptoms.

3. Antiseizure medications

Antiseizure medications are used to prevent and manage seizures and treat specific types of nerve pain. Some medications, including Dilantin (phenytoin) and Tegretol (carbamazepine), can trigger an abnormal immune reaction in the liver known as hypersensitivity syndrome, which can harm surrounding tissues. Valproic acid (Depakene) and lamotrigine (Lamictal) are medications that can also impact the liver.

Your doctor may perform blood tests to monitor your liver. Based on the test results, your doctor may modify your dosage or change your medication.

4. Methotrexate

Methotrexate treats certain cancers, autoimmune diseases, and inflammatory conditions such as rheumatoid arthritis. Your liver may be affected if you take Methotrexate for an extended period or at high doses. The risk increases if you drink alcohol or already have liver problems.

Your doctor may conduct blood tests to assess your liver function and adjust your medication if necessary. To protect your liver, avoid drinking alcohol while taking Methotrexate.

5. Antifungal medications

Antifungal medications are used to treat fungal infections of the skin, lungs, and nails. The length of treatment depends on the specific type of infection you have. Diflucan (fluconazole), Sporanox (itraconazole), Nizoral (ketoconazole), and other antifungal medications are often prescribed for short-term use. These medications can affect the liver, with potential consequences ranging from a slight increase in liver enzymes (which is generally not concerning and can be monitored) to inflammation and, in rare cases, liver failure.

To protect your liver, be on the lookout for jaundice (yellowing skin or eyes), tiredness, or dark urine. If you notice these symptoms, contact your doctor immediately. Your doctor may order blood tests or adjust your medication if needed.

6. Amiodarone (Cordarone, Pacerone)

Amiodarone treats and prevents life-threatening irregular heartbeats (arrhythmias). Amiodarone can elevate liver enzyme levels or, in rare cases, can scar the liver. Because this medication affects up to 1 percent of people who take it every year, the U.S. Food and Drug Administration (FDA) has issued a boxed warning about the risk of liver injury with this medication. Your doctor will check liver enzyme levels before starting the medication and during treatment.

7. Isoniazid (INH, Nydrazid, Rifater)

Isoniazid is an antibiotic used for treating tuberculosis and preventing its return. The liver breaks down Isoniazid and can cause problems from mild inflammation to severe liver injury, especially in older adults, people with liver conditions, or those who drink alcohol.

The medication also has an FDA-boxed warning about liver inflammation risk, particularly when combined with certain medications. If you experience nausea, vomiting, jaundice (yellow skin or eyes), or dark urine, contact your doctor immediately.

Certain Herbal and Dietary Supplements

Some people prefer taking herbal and dietary supplements over prescription medications. The FDA does not regulate herbal or dietary supplements like it does prescription medications. So, the ingredients in products can differ, and some may pose potential harm.

While these herbal and dietary products are promoted for having various health benefits, some, like Kava (Piper methysticum) and black cohosh (Cimicifuga racemosa), may cause liver damage. Kava, an herb commonly used for anxiety and sleeping problems, has been linked to severe liver damage, though the exact cause is not clear. Black cohosh is most commonly used for menopausal symptoms, such as hot flashes and night sweats. The herb has been associated with liver problems, such as an increase in liver enzymes and liver failure. Over 30 cases of liver injury connected to these supplements have been reported in the United States.

Consult your doctor before using these products because “natural doesn’t always mean safe.” Avoid them if you already have liver problems.

Work With Your Doctor

To help protect your liver, Dr. Ikezuagu recommends taking your medications exactly as prescribed and talking to your doctor first before changing your dosage or combining prescription drugs, over-the-counter medications, and supplements.

Source Link:

https://www.aarp.org/health/drugs-supplements/medications-that-harm-liver/