- birth control pills -Drugs to prevent pregnancy are so widely used that the side effects are rarely considered.
- antidepressants - There are many types of drugs that treat depression.
- antipsychotic medications - Drugs that treat psychosis can also cause fatty liver disease.
- valproic acid - This is an anti-epilepsy drug.
- diltiazem - This prescription medication is a heart medication that is called a calcium channel blocker.
- indinavir - You wouldn't know much about this prescription medication unless you had HIV. It's a drug reserved for those who have HIV.
- tamoxifen - This is a prescription drug based on an ingredient from the Pacific Yew tree. It's used as an anti-estrogen medication for those who have breast cancer and is part of the treatment plan for cancer patients.
- high dosage of intravenous tetracycline - You have to be pretty sick to end up with a high dosage of intravenous tetracycline. It's one that is used in the Intensive Care Unit in the hospital.
- alcohol - As little as two drinks a day for women and three drinks a day for men can cause the appearance of fatty liver disease.
- cigarettes - Fatty liver disease is one of those hidden health problems of cigarettes you never thought of.
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- sedatives - These are drugs that calm you down.
- corticosteroids - Two primary steroid drugs are cortisone and prednisone.
- methotrexate - This is a potentially-dangerous medication used as a last resort for rheumatoid arthritis.
- Amiodarone - This medication treats abnormal heart rhythms.
- sulfonamides - This medication treats infections; these drugs also use up para-amino-benzoic acid (PABA), a B vitamin, in the body which is used to synthesize folic acid in the intestines.
- phenytoin - This anti-epilepsy medication is especially used for grand mal seizures.
- antithyroid drugs - The primary medication in this category are the ones used for hyperthyroidism.
- phenothiazines - These drugs treat schizophrenia and other psychotic disorders.
- salicylates - These are aspirin-based medications that treat mild to moderate pain.
When drugs harm the liver and cause fatty liver, they cause the elevation of liver enzymes. Three of the most important liver enzymes are found on liver function tests, and are called SGOT or AST for short, ALT or SGPT, and alkaline phosphatase.
There are three types of liver injuries:
1. Hepatocellular injury - If this type of injury shows jaundice as one of the symptoms, the person may be a candidate for a liver transplant. Two drugs that can cause this injury are acetaminophen and isoniazid as well as the gout medicine allopurinol; NSAIDS Omeprazole, Paroxetine, Rifampin, Sertraline; Lisinopril, Losartan and Methotrexate, Baclofen, Statins, Tetracyclines, Trazodone, and Risperidone. The injury is reflected in elevated ALT enzymes.
2. Cholestatic - This type of injury is not as bad as hepatocellular injury, but it may destroy the bile ducts and cause itching skin as well as jaundice. Cholestatic injuries show high alkaline phosphatase and total bilirubin. Drugs that cause it include oral contraceptives, amoxicillin, estrogens, Mirtazapine, Terbinafine, Phenothiazines, Erythromycins, and Anabolic steroids.
3. Mixed - This injury is reflected by similar lab test findings as the hepatocellular injury and the cholestatis injury. It's caused by the drug phenytoin. Drugs responsible include Amitriptyline, Captopril, Sulfonamides, Trazodone, Verapamil, Phenobarbital, Clindamycin, Carbamazepine, and Trimethoprim. Treatment for these liver injuries starts with removal of the prescription medication causing them.
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