hepatic and biliary disorders
Liver Injury Caused by Drugs
Introduction
Many medications (eg, statins) commonly cause asymptomatic elevation of hepatic enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST], alkaline phosphatase). However, clinically significant liver injury (eg, with jaundice, abdominal pain, or pruritus) or impaired liver function—ie, resulting in deficient protein synthesis (eg, with prolonged prothrombin time [PT] or with hypoalbuminemia)—is rare. Withholding statin therapy in patients with chronic liver disease is not recommended. Statin use in patients with chronic liver disease is not different from its use in patients without baseline liver disease. In contrast, statins may have antifibrotic properties and can benefit patients with nonalcoholic steatohepatitis (NASH) and Metabolic Dysfunction–Associated Liver Disease (MASLD) (NAFLD), ( The term drug-induced liver injury (DILI) may be used to mean clinically significant liver injury or all (including asymptomatic) liver injury. DILI includes injury caused by Overview of Dietary Supplements as well as medications ( 