Drug induced liver injury medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rachita Navara, M.D. [2]

The mainstay of therapy for drug induced liver injury is prompt withdrawal of the offending drug.

The mainstay of therapy for drug induced liver injury is prompt withdrawal of the offending drug. It has been hypothesized that early drug withdrawal prevents progression to acute liver failure, but there is insufficient data to support this, as sometimes even a few days of exposure to a drug can cause a fatal outcome.

There are no FDA approved antidotes for idiosyncratic drug induced liver injury. N-acetylcysteine has only been approved for acetaminophen-induced liver injury.^[1]

Corticosteroid therapy has also been proposed as treatment for acute liver failure resulting from drug induced liver injury. However, unlike for alcoholic and autoimmune hepatitis, there are no controlled trials to support this therapy for drug induced liver injury.

Symptoms such as pruritis can be managed with antihistamines including hydroxyzine and diphenhydramine.