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Drug induced liver injury ( DILI )

  • Author: Dr. Hasan Altarrah
  • Published Date: 10/05/2026
  • Last Modified Date:
  • Rating :
  • Reviews: ( 0 Reviews )
  • Category :Internal Medicine
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Additional Information:

  • CC: High LFT

Description

Diagnosis
  • Drug induced liver injury (DILI)
Examples
  • Herbal medications
  • Over-the-counter drugs
  • Anti-TB medications
  • Acetaminophen
  • Augmentin
  • Anti epileptics like phenytoin & valproate
  • Statins
Diagnostic Criteria

At least one of the following:

  • Serum AST or ALT > 5 times upper limit of normal OR ALK PHOSPH > 2 times upper limit of normal (or baseline value if baseline is elevated) on two separate occasions
  • Total bilirubin > 42.7 umol/L with elevated AST, ALT or ALP
  • INR > 1.5 with elevated AST, ALT or ALP
What Will You Do?
  • Discontinue offending drug if above criteria are fulfilled, otherwise close observation
  • +/- Hepatology consult, Neurology consult (for anti epileptic drugs)

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