A variety of drugs can cause abnormal levels of liver enzymes in some individuals, including: pain relievers, anti-seizure drugs, antibiotics, cholesterol-lowering drugs, Cardiovascular drugs, etc. It is organized as follows:
Potentially Hepatotoxic Drugs
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1. Painkillers:
aspirin ;
acetaminophen (Tylenol, etc.);
ibuprofen (Advil, ibuprofen);
naproxen (naproxen) , naproxen sustained-release tablets);
diclofenac sodium (Voltaren, Voltaren sustained-release tablets);
butazone.
2. Antiepileptic drugs:
phenytoin ( phenytoin);
valproic acid (divalproex sodium);
carbamazepine (carbamazepine tablets);
phenobarbital .
3. Antibiotics:
Tetracycline antibiotics ( For example, tetracycline);
sulfonamides;
isoniazid (INH);
sulfamethoxazole; oxybenzidine;
nitrofurantoin (nitrofurantoin; nitrofurantoin capsules);
fluconazole and some other antifungal drugs, etc.
4. Cholesterol-lowering drugs:
Lova
pravastatin;
atorvastatin;
fluvastatin;
simvastatin;
Rosuvastatin;
Niacin.
5. Cardiovascular Drugs:
Amioodine ketone;
hydralazine;
quinidine, etc.
6. Other drugs:
Tricyclics Antidepressants.
Drug-induced liver enzyme abnormalities usually resolve within weeks or months of stopping the drug. Typically, a doctor will want to monitor changes in a patient’s liver enzymes over time to see if liver enzyme levels are normalizing.
Conditions leading to extremely high AST and ALT levels
Certain conditions that lead to rapid death of large numbers of liver cells (extensive hepatic necrosis) tend to have high AST and ALT levels. Although this degree of liver enzyme elevation is uncommon, it can be seen in the following conditions:
• Acute hepatitis A or B
• Severe liver damage from toxins such as excess acetaminophen or mushroom poisoning
• Long-term breakdown of the circulatory system (shock) when the blood supplying oxygen and nutrients to the liver is reduced (shock)
In addition, severe muscle disease also has very high AST and ALT levels.
Uncommon causes of elevated liver enzymes
• Hemochromatosis is a genetic disorder in which a high iron diet causes iron to accumulate in the liver, leading to inflammation and scarring of the liver. If undiagnosed or untreated, hemochromatosis can progress to cirrhosis and liver failure.
• Wilson’s disease is an inherited disorder in which copper accumulates excessively in various tissues, including the liver and brain. Too much copper in the liver can lead to chronic liver inflammation, while copper in the brain can cause psychosis and movement disorders.
• Alpha-1-antitrypsin deficiency is an inherited disorder in which a glycoprotein called alpha-1-antitrypsin is deficient, resulting in chronic lung disease (emphysema) and chronic liver disease.
• Celiac disease is a disease of the small intestine. Mildly abnormal ALT and AST levels can also occur in patients with celiac disease.
• Crohn’s disease and ulcerative colitis are chronic inflammatory diseases of the gut (collectively known as inflammatory bowel disease). In these individuals, inflammation of the liver (hepatitis) or cholangitis (primary sclerosing cholangitis) may also occur, causing abnormal liver tests.
Yimaitong compiled from: Liver Blood Tests:Understand Liver Blood Test Results.MedicineNet.