are diabetes medications hepatotoxic

are diabetes medications hepatotoxic

Is metformin hepatotoxic?

Metformin is not considered intrinsically hepatotoxic. In fact, metformin may be beneficial in patients with nonalcoholic fatty liver disease (1) and chronic hepatitis C (3). Metformin is only contraindicated in patients with advanced cirrhosis because it heightens the risk of developing lactic acidosis (4).

Which medication will cause hepatotoxicity?

The 10 most frequently implicated drugs were: amoxicillin-clavulanate, flucloxacillin, erythromycin, diclofenac, sulfamethoxazole/Trimethoprim, isoniazid, disulfiram, Ibuprofen and flutamide [12,13,14,21].

Can metformin cause high ALT?

(Analysis of more than 6000 patients in industry sponsored clinical trials found ALT levels >3 times ULN in 1.9% of troglitazone, 0.32% of rosiglitazone, 0.26% of pioglitazone, 0.40% of sulfonylurea and metformin, vs 0.17% of placebo treated patients; no mention of severe liver toxicity or jaundice).

Is metformin nephrotoxic?

Metformin itself is not a nephrotoxic drug. Initially appointed as the safest hypoglycemic agent in chronic kidney disease, its use has been limited in these patients because of the perceived risk of lactic acidosis.

Why are drugs hepatotoxic?

Hepatotoxicity is the injury or liver damage caused by exposure to drugs; it is an adverse drug reaction that may be uncommon but serious. The hepatic injury can be classified into hepatocellular, cholestatic and mixed, caused by increase in alanine aminotransferase and alkaline phosphatase than upper limit of normal.

Are ALT and AST liver enzymes?

ALT is an enzyme found in the liver that helps convert proteins into energy for the liver cells. When the liver is damaged, ALT is released into the bloodstream and levels increase. Aspartate transaminase (AST). AST is an enzyme that helps metabolize amino acids.

Is sulfonylureas hepatotoxic?

First-generation sulfonylureas include tolbutamide (Orinase), tolazamide (Tolinase), and chlorpropamide (Diabinese). Chlorpropamide and tolbutamide are well recognized as causes of hepatotoxicity. However, there have been only three reported cases of hepatic injury caused by a third oral hypoglycemic agent, tolazamide.

Does glipizide affect the liver?

Gastroenterology suspected glipizide induced liver injury in the setting of significant improvement in liver enzymes after medication cessation. Patient declined a rechallenge. Hepatotoxicity is a rarely reported side effect for sulfonylureas.

Does metformin affect the liver or kidneys?

Metformin does not cause kidney damage. The kidneys process and clear the drug out of your system via urine. If your kidneys are not functioning properly, metformin can build up in your system and cause a condition called lactic acidosis. Lactic acidosis is when there is a dangerous amount of lactic acid in the body.

Are statins nephrotoxic?

Recent reports indicate that statins can cause nephrotoxicity. However, the mechanisms of nephrotoxicity remain unclear. We report a case of acute kidney injury (AKI) in a 54-year-old man following the administration of atorvastatin Renal biopsy showed acute interstitial nephritis.

What is the most common cause of elevated liver enzymes?

The most common causes of elevated transaminase levels are nonalcoholic fatty liver disease and alcoholic liver disease. Uncommon causes include drug-induced liver injury, hepatitis B and C, and hereditary hemochromatosis.

Are NSAIDs hepatotoxic?

Unlike acetaminophen (Tylenol), most NSAIDs are absorbed completely and undergo negligible liver metabolism. In other words, the way NSAIDs are metabolized makes liver injury ( hepatotoxicity) very rare. Estimates are that 1 to 9 in 100,000 NSAID prescriptions result in acute liver injury.

What are hepatotoxic effects?

Hepatotoxicity is defined as injury to the liver or impairment of the liver function caused by exposure to xenobiotics such as drugs, food additives, alcohol, chlorinated solvents, peroxidized fatty acids, fungal toxins, radioactive isotopes, environmental toxicants, and even some medicinal plants [6,77,78].

What medications can cause elevated bilirubin?

Drugs that can increase bilirubin measurements include allopurinol, anabolic steroids, some antibiotics, antimalarials, azathioprine, chlorpropamide, cholinergics, codeine, diuretics, epinephrine, meperidine, methotrexate, methyldopa, MAO inhibitors, morphine, nicotinic acid, oral contraceptives, phenothiazines, …

Is 300 high for liver enzymes?

Elevated values up to 300 U/L are considered nonspecific. Marked elevations of ALT levels greater than 500 U/L observed most often in persons with diseases that affect primarily hepatocytes such as viral hepatitis, ischemic liver injury (shock liver) and toxin-induced liver damage.

What AST and ALT levels indicate liver disease?

A normal AST:ALT ratio should be <1. In patients with alcoholic liver disease, the AST:ALT ratio is >1 in 92% of patients, and >2 in 70%. AST:ALT scores >2 are, therefore, strongly suggestive of alcoholic liver disease and scores <1 more suggestive of NAFLD/NASH.

What causes elevated AST and ALT?

Chronic alcohol consumption, drugs, non-alcoholic steatohepatitis (NASH) and chronic viral hepatitis are common causes associated with raised ALT and AST. In chronic viral hepatitis, the elevation of liver enzyme may not correlate well with the degree of liver damage.

Is glimepiride hepatotoxic?

Drug induced hepatotoxicity has been reported infrequently with sulfonylureas. For glimepiride, a second-generation sulfonylurea there is no report of hepatotoxicity in English literature.

Is gliclazide hepatotoxic?

There are few reports in the literature related to sulfonylurea-induced hepatotoxicity. We describe the case of acute hepatitis induced by gliclazide, a second generation sulfonylurea.

What is TZD medication?

Thiazolidinediones, or TZDs, help decrease blood glucose (sugar) levels by reducing insulin resistance and making the body respond to insulin. TZDs also reduce the amount of glucose produced by the liver.