Hepatic injury from agents in this category is rare. For example, only a handful of cases of H2-receptor antagonist-related liver injury have been reported despite the hundreds of millions of doses prescribed since the introduction of these drugs more than 15 years ago. Hepatotoxicity from sulfasalazine is uncommon but may be fatal. Injury from other agents used to treat inflammatory bowel disease also may be seen, including veno-occlusive disease from azathioprine. Of increasing importance is the toxicity from alternative health supplements, such as herbal remedies, that may cause acute, sometimes fatal, hepatic necrosis.