Health Encyclopedia

Drug-induced cholestasis

Definition

Drug-induced cholestasis is a blockage in the flow of bile from the liver that occurs with medication use.

Alternative Names

Cholestasis - drug-induced

Causes, incidence, and risk factors

Bile is produced in the liver, moved to the gallbladder, and released into the gut through the biliary tract. It helps the body digest fats.

Certain drugs can slow or stop the flow of bile from the liver to the gallbladder and gut, which may damage the liver.

Many drugs can cause cholestasis, including:

Ampicillin and other penicillin-based antibiotics
Anabolic steroids
Chlorpromazine
Cimetidine
Erythromycin
Gold salts
Imipramine
Nitrofurantoin
Oral contraceptives
Prochlorperazine
Sulindac
Tobutamide

Other medications can also cause cholestasis in some people.

Symptoms

Fever or rash from the drug
Itching
Nausea
Pain in the upper right part of the abdomen
Very dark urine
Very pale stools
Vomiting
Yellow skin or eyes (jaundice)

Signs and tests

High bilirubin and alkaline phosphatase.

Treatment

If medication is causing the cholestasis, the doctor will probably tell you to stop taking the drug and will prescribe an alternative, if possible. DO NOT stop taking medications on your own without talking to your doctor. There is no medicine to reverse drug-induced cholestasis.

Expectations (prognosis)

Most patients recover, but severe cases may lead to liver failure. Drug-induced cholestasis usually reverses after you stop taking the medication or drug. However, it may take many months for cholestasis to get better.

Complications

Diarrhea
Poor absorption of fat and fat-soluble vitamins
Severe itching

Calling your health care provider

Call your health care provider if you have persistent itching or notice that your skin or eyes are yellow.

Review Date:8/22/2008
Reviewed By:Christian Stone, MD, Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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