eMedicine Specialties > Gastroenterology > Liver

Isoniazid Hepatotoxicity: Treatment & Medication

Author: Richard A Weisiger, MD, PhD, Director, GI and Liver Faculty Practice, Professor, Department of Internal Medicine, University of California San Francisco
Contributor Information and Disclosures

Updated: Jun 21, 2007

Treatment

Medical Care

  • The medical care is supportive only.
  • Discontinue isoniazid and any other potentially toxic drug, and closely monitor the patient.
  • Hospitalize persons who are more severely affected (eg, with significant elevation of the prothrombin time) for monitoring and potential liver transplantation. Care of such patients is identical to that for other causes of fulminant hepatitis.

Consultations

  • Patients with elevations of the serum transaminases greater than 3 times the normal level should be evaluated by a hepatologist or gastroenterologist to carefully consider all possible causes of hepatitis.
    • Consultation also should be obtained for those with lesser elevations that do not resolve within 2-3 months.
    • Elevation of the prothrombin time should prompt hospitalization with evaluation for possible liver transplantation.

Activity

No restrictions are necessary unless the prothrombin time is elevated. Activity often is limited by fatigue.

More on Isoniazid Hepatotoxicity

Overview: Isoniazid Hepatotoxicity
Differential Diagnoses & Workup: Isoniazid Hepatotoxicity
Treatment & Medication: Isoniazid Hepatotoxicity
Follow-up: Isoniazid Hepatotoxicity
Multimedia: Isoniazid Hepatotoxicity
References
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References

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Further Reading

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Keywords

isoniazid hepatitis, isonicotinic acid hydrazide, INH, antituberculosis therapy, jaundice, liver failure, drug toxicity

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Contributor Information and Disclosures

Author

Richard A Weisiger, MD, PhD, Director, GI and Liver Faculty Practice, Professor, Department of Internal Medicine, University of California San Francisco
Richard A Weisiger, MD, PhD is a member of the following medical societies: American Association for the Study of Liver Diseases, American Gastroenterological Association, and American Society for Clinical Investigation Central
Disclosure: Nothing to disclose.

Medical Editor

Terence David Lewis, MBBS, FRACP, FRCPC, FACP, Program Director, Internal Medicine Residency, & Assistant Chairman, Associate Professor, Department of Internal Medicine, Division of Gastroenterology, Loma Linda University Medical Center
Terence David Lewis, MBBS, FRACP, FRCPC, FACP is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Medical Association, California Medical Association, Royal College of Physicians and Surgeons of Canada, and Sigma Xi
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Douglas M Heuman, MD, FACP, Director of Hepatology, McGuire Veterans Affairs Medical Center, Professor, Department of Internal Medicine, Division of Gastroenterology, Virginia Commonwealth University School of Medicine
Douglas M Heuman, MD, FACP is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Physicians, and American Gastroenterological Association
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Assistant Dean for Medical Curriculum, Associate Professor of Medicine, Division of General Internal Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD, Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania
Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law Medicine and Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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