Some medications may be poorly tolerated or toxic to the liver and can lead to drug-induced hepatitis, which is, in most cases, harmless if caught early.
What is drug-induced hepatitis?
Drug-induced hepatitis, also called “drug hepatotoxicity”, East liver inflammation caused by taking medications, medicinal plants, herbs or nutritional supplements. Indeed, certain medications may have side effects that affect the liver clinically significant (i.e. symptomatic) or not (liver damage without symptoms), immediately describes Dr. Laura Granconato, gastroenterologist and hepatologist. Medications can cause drug-induced hepatitis in different ways. Some are directly toxic to the liver, while others can trigger an immune response that is toxic to the liver. Note that all medications do not necessarily cause hepatitis, some only cause an elevation of liver enzymes without symptoms; And most medications are well tolerated by people. “Some individuals may be more likely to develop drug-induced hepatitis due to genetic factors or other underlying medical conditions like young age, obesity, current pregnancy or excessive alcohol consumption chronic“, lists our expert.
Because of paracetamol?
Paracetamol (active substance in particular Doliprane®) is a medicine widely used to relieve pain and reduce fever, it is contained in more than 200 specialties alone or combined with other substances. “Although paracetamol is generally safe when used as directed, excessive doses or “overdose” can lead to serious liver damage or even liver failure.continues the specialist.
“Hepatitis due to paracetamol is one of the main causes of severe acute liver failure”
Drug-induced hepatitis due to paracetamol is one of the main causes of severe acute liver failure in numerous countries. When paracetamol is metabolized in the liver, it produces a toxic metabolite. In general, this metabolite is neutralized by glutathione, a substance naturally present in the liver; itself restored by N Acetyl Cysteine. However, when a person takes excessive doses of paracetamol, the stock of NAC is depleted and does not allow glutathione to be regenerated, thus leading to liver damage through accumulation of the toxic metabolite.
What are the symptoms of drug-induced hepatitis?
Symptoms of drug-induced hepatitis can vary depending on the drug, the severity of the reaction, and the individual. They generally include:
- A jaundice (yellow discoloration of the skin and whites of the eyes)
- Itching or feeling of itchy skin
- A general feeling of fatigue and weakness
- Nausea and vomiting
- Abdominal pain
- Of the dark urine
- In some cases, a fever low
In some cases, symptoms may take time to appear. “Additionally, these symptoms are not specific to drug-induced hepatitis and may also be associated with other health conditions, such as viral, biliary, alcoholic, autoimmune, or metabolic liver disease.“, the interviewee wishes to clarify.
Diagnosis generally requires blood tests with the liver enzyme assays, of the bilirubin and other markers to assess liver function and determine the underlying cause of symptoms. Only a doctor can decide whether or not to stop treatment. If in doubt, consult a healthcare professional.
Treatment: what to do in case of drug-induced hepatitis?
Treatment for drug-induced hepatitis depends on several factors, the substance involved, the severity of the symptoms, and the general health of the patient. Here are some things to consider:
► Early discontinuation of the offending medication: If drug-induced hepatitis is caused by a specific medication, the first action is usually to stop taking that medication. “The stop usually results in a recovery. However, this should be done under the supervision of a healthcare professional, as abruptly stopping certain medications can also have negative consequences.”underlines our interlocutor.
► Symptomatic treatment to relieve symptoms such as fatigue, nausea and abdominal pain. This may include medications to relieve pain or antiemetics to control nausea and vomiting, however taking a new medication requires strict medical supervision as it risks adding to or worsening the liver toxicity already present.
► Regular blood tests will be carried out to assess liver function and monitor proper recovery.
► Un specific treatment may be needed to treat complications or speed recovery. “For example, if the person has developed severe liver failure, they may require hospitalization and intensive care, as well as taking a specific antidote or medication. corticosteroids”.
People who have had drug-induced hepatitis may be more sensitive to hepatotoxic drugs in the future, and this must be taken into account when prescribing any future medication. In fact, you should never reintroduce medications that have caused liver damage. without specialist advice.
What is the healing time?
Recovery time from drug-induced hepatitis can vary greatly from person to person. “In most cases, drug-induced hepatitis resolves quickly once the offending drug is stopped and appropriate supportive measures are taken. This may take a few weeks to a few months, replies Dr. Granconato. However, in more severe cases, particularly those involving severe liver failure, recovery may take longer, and long-term medical monitoring may be necessary.”.
In most cases, drug-induced hepatitis is reversible
Is it mortal?
Drug-induced hepatitis can be potentially fatal. The severity depends on several factors, including the dose of the offending medication, how quickly it is identified and stopped, the patient’s overall health, and whether there are pre-existing risk factors. “In most cases, drug-induced hepatitis is reversible if the responsible drug is identified and eliminated in time, concludes the specialist. However, in severe cases, liver inflammation can progress to severe liver failure and up to one fulminant hepatitis which can be fatal”.
Thanks to Dr Laura Granconato, gastroenterologist and hepatologist at the Clinique du Parc in Castelnau le Lez (34)