Drug Hepatotoxicity: Newer Agents

Clin Liver Dis. 2017 Feb;21(1):115-134. doi: 10.1016/j.cld.2016.08.009. Epub 2016 Oct 14.


Idiosyncratic hepatotoxicity is one of the most common reasons for an approved drug being restricted. This article focuses on hepatotoxicity of selected and recently introduced agents, such as, tyrosine kinase inhibitors, monoclonal antibodies, novel oral anticoagulants, newer antiplatelets, antibiotics, anti-diabetics, anti-epileptics, anti-depressants, anti-psychotics and anti-retrovirals. Overall, the incidence of clinically relevant hepatotoxicity from newer agents seems to be lower than that of the older agents. Nevertheless, cases of severe hepatotoxicity have been reported due to some of these newer agents, including, trastuzumab, ipilimumab, infliximab, imatinib, bosutinib, dasatinib, gefitinib, erlotinib, sunitinib, ponatinib, lapatinib, vemurafenib, dabigatran, rivaroxaban, felbamate, lamotrigine, levetiracetam, venlafaxine, duloxetine, darunavir, and maraviroc.

Keywords: Antibiotics; Anticoagulants; Antiplatelet; Antiretrovirals; Drug-induced liver injury; Hepatotoxicity; Monoclonal antibodies; Tyrosine kinase inhibitors.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects
  • Anti-Retroviral Agents / administration & dosage
  • Anti-Retroviral Agents / adverse effects
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / adverse effects
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects
  • Chemical and Drug Induced Liver Injury / epidemiology*
  • Chemical and Drug Induced Liver Injury / etiology*
  • Chemical and Drug Induced Liver Injury / physiopathology
  • Drugs, Investigational / administration & dosage
  • Drugs, Investigational / adverse effects*
  • Female
  • Humans
  • Incidence
  • Liver / drug effects*
  • Liver / metabolism
  • Male
  • Pharmaceutical Preparations*
  • Risk Assessment
  • United States / epidemiology


  • Anti-Bacterial Agents
  • Anti-Retroviral Agents
  • Antibodies, Monoclonal
  • Anticoagulants
  • Drugs, Investigational
  • Pharmaceutical Preparations