Prescription medicines

Many prescription medicines are linked to liver injury. Some common examples include:

• Antibiotics such as amoxicillin-clavulanate (Augmentin).
• Antiseizure medicines such as phenytoin (Dilantin, Phenytek).
• The immunosuppressant medicine azathioprine (Azasan, Imuran).
• Niacin (Niacor).
• The antifungal medicine ketoconazole.
• Certain antiviral medicines.
• Anabolic steroids.

Other prescription medicines can be more dangerous, specifically in people who already have liver disease. These include:

• Opioids such as oxycodone, tramadol, morphine and others: In people with cirrhosis, these drugs can increase the risk of hepatic encephalopathy. This is a serious condition that occurs when the liver is not able to filter toxins from the blood. The buildup of toxins affects the brain's ability to function.
• Proton pump inhibitors such as pantoprazole, rabeprazole, omeprazole and others: These medications may increase infection risk in people with cirrhosis.
• Cancer immunotherapy medications, also called immune checkpoint inhibitors: These medicines include isoniazid, methotrexate, nitrofurantoin, rifampin, tamoxifen and others. They can raise liver enzyme levels.
• Diabetes medications such as glyburide, glipizide and pioglitazone: People who have advanced cirrhosis due to risk of low blood sugar should avoid taking these medicines.