Drug Induced Liver Injury (DILI) Or Toxin Exposures

Prescribed, intentional overdose, related to supplements/herbals/non-prescribed

Your Path

  • Drug Induced Liver Injury (DILI) or Toxin Exposures


  • Statins
  • Herbals, supplements, other non-prescribed
  • Anti-TB meds (e.g. INH, rifampin, other)
  • Antibiotics: many, though amoxicillin/clavulonic acid most common world wide)
  • Anti-epileptic Drugs (e.g. valproate, carbamazepine, dilantin, other)
  • Other: steroids, OCPs, acetaminophen (the most common cause of DILI in US), Ace-I, anti-fungals, anti-retrovirals, PTU, toxins (e.g. amanita mushrooms), and more
  • May have chronic/underlying liver disease (e.g. NAFLD, Hep C, ETOH) with additional med/toxin effect superimposed


  • Range from non-specific to fulminant liver failure
  • Jaundice, edema, mild confusion to coma - depending on degree of end organ dysfunction

Physical Exam Findings

  • Appearance ranges from no acute distress to very ill