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Risk factors
By Mayo Clinic staffYour risk for toxic hepatitis increases if you:
- Take over-the-counter pain relievers or certain prescription drugs. This is especially true if you take these medications for an extended time or in higher than recommended amounts.
- Have another liver disease. Having a serious liver disorder such as cirrhosis or fatty liver disease makes you much more susceptible to the effects of toxins.
- Have viral hepatitis. If you have viral hepatitis — such as hepatitis A, B or C — and take even normal doses of acetaminophen, you have a greatly increased risk of developing toxic hepatitis.
- Are an older adult. As you age, your liver breaks down harmful substances more slowly. This means that toxins and their byproducts stay in your body longer.
- Drink alcohol. Combining medications with even moderate amounts of alcohol — no more than two drinks a day for men or one for women — significantly increases the toxic effects of most drugs. Heavy drinkers who take acetaminophen even at recommended doses are at risk of acute liver failure.
- Are female. Because women seem to metabolize certain toxins more slowly than men do, their livers are exposed to higher blood concentrations of harmful substances for longer periods of time.
- Have certain gene defects. Inheriting certain defects in the liver enzymes that break down toxins may make you more susceptible to toxic hepatitis.
- Are exposed to industrial toxins. Working with certain industrial chemicals puts you at risk of toxic hepatitis.
References
- Dienstag JL. Toxic and drug-induced hepatitis. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill; 2008. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Nov. 14, 2008.
- Lewis JH. Liver disease caused by anesthetics, toxins, and herbal preparations. In: Feldman M, et al. Sleisenger & Fordtran's Gastroinstestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/111481204-2/0/1389/0.html. Accessed Nov. 11, 2008.
- Friedman LS. Liver, biliary tract, & pancreas disorders. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment 2009. 48th ed. New York, N.Y.: McGraw-Hill; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed Nov. 11, 2008.
- Brown JA. Haz-Map: Information on hazardous chemicals and occupational disease. National Institutes of Health. http://hazmap.nlm.nih.gov. Accessed Nov. 12, 2008.
- Fountain FF. Isoniazid hepatotoxicity associated with treatment of latent tuberculosis infection: A 7-year evaluation from a public health tuberculosis clinic. Chest. 2005;128:116.
- Fontana RJ. Acute liver failure including acetaminophen overdose. Medical Clinics of North America. 2008;92:761.
- Fontana RJ. Acute liver failure due to drugs. Seminars in Liver Disease. 2008;28:175.
- Watkins PB. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily. Journal of the American Medical Association. 2006;296:87.
- NCI drug dictionary. National Cancer Institute. http://www.cancer.gov/drugdictionary. Accessed Nov. 14, 2008.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Oct. 28, 2008.
