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Updated: Aug 5, 2026
11:06
Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
Common Causes of Drug-Induced Liver Injury in 2025
1University of Iceland Faculty of Medicine, Reykjavik, Iceland.
Summary
Drug-induced liver injury (DILI) is evolving, with new antibiotic and herbal supplement risks emerging. Early recognition and withdrawal of offending agents are crucial for managing liver damage and preventing severe outcomes like liver transplantation.
Area of Science:
- Hepatology
- Clinical Pharmacology
- Toxicology
Background:
- Drug-induced liver injury (DILI) is a significant clinical concern, often presenting with elevated liver enzymes.
- Antibiotics have historically been the most frequent cause of DILI.
- Recent findings highlight evolving patterns in DILI etiology.
Purpose of the Study:
- To review the changing landscape of drug-induced liver injury.
- To identify newly recognized hepatotoxic agents and phenotypes.
- To emphasize the importance of differential diagnosis in DILI.
Main Methods:
- Literature review of recent studies on DILI.
- Analysis of case reports and clinical studies on drug-induced liver injury.
- Synthesis of data on emerging hepatotoxic agents, including antibiotics and herbal supplements.
Main Results:
- A new cefazolin phenotype causes cholestatic reactions after minimal exposure.
- Ornidazole has been linked to severe hepatocellular jaundice requiring liver transplantation.
- Anticancer drugs (especially checkpoint inhibitors) and various herbal and dietary supplements (HDSs) are increasingly implicated in DILI.
- HDSs like Polygonum multiflorum and ashwagandha can cause acute liver failure.
Conclusions:
- The spectrum of DILI is expanding with new drug classes and supplements.
- Prompt identification and cessation of the causative agent are vital for patient recovery.
- Awareness of emerging hepatotoxins is critical for clinicians managing liver injury.
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