Drug-induced cholestasis

Definition

Drug-induced cholestasis is a slowing of the flow of bile from the liver that results from medication use.

Alternative Names

Cholestasis - drug-induced

Causes, incidence, and risk factors

Bile is produced in the liver, moved via the bile duct 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 estolate
Estradiol
Gold salts
Imipramine
Nitrofurantoin
Oral contraceptives
Prochlorperazine
Sulindac
Terbinafine
Tolbutamide

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

Treatment

If a 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.

Cholestyramine (or colestipol) may reduce the itching.

Vitamin replacement therapy restores vitamins A, K, and D, which are lost in fatty stools. A calcium supplement should be added to prevent or treat soft, weakened bones (osteomalacia).

Support Groups

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.

Prevention

visHeader

References

Afdhal NH. Diseases of the gall bladder and bile ducts. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 159.

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Review Date: May 4, 2010

A.D.A.M. quality A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process, and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation ( www.HONcode.ch.)

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. ©1997-2012 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Popular Health Centers

Allergy

Asthma

Health Products

Sign Up for Free Newsletters

Ask Your Doctor the RIGHT Questions!

Get FREE tools and tips to get
the most from your doctor visit.
Emailed right to you!
The Ask Your Doctor email series
may contain sponsored content.
18+, US residents only please.