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Semin Liver Dis 2014; 34(02): 205-214
DOI: 10.1055/s-0034-1375960
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Drug-Induced Hepatic Steatosis

David E. Amacher
1   Sciadvisor Toxicology Consulting, Hadlyme, Connecticut
,
Naga Chalasani
2   Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
› Author Affiliations
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Publication History

Publication Date:
31 May 2014 (online)

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Abstract

Several drugs have been associated with the potential for drug-induced hepatic steatosis (DIHS) and/or phospholipidosis (DIPL), a lysosomal storage disorder. Drug-induced hepatic steatosis is generally a chronic but reversible affliction and may involve drug accumulation in the liver. Fat accumulation may be either macrovesicular or microvesicular in nature. Commonly used medications associated with DIHS include amiodarone, valproate, tamoxifen, methotrexate, and some chemotherapeutic and antiretroviral agents. Two recently approved medications for the treatment of hereditary homozygous hypercholesterolemia have also been noted to cause hepatic steatosis. For some compounds such as methotrexate and tamoxifen, the underlying metabolic risk factors such as obesity and metabolic syndrome may exacerbate their potential to cause DIHS and its progression. In this article, the authors discuss the preclinical screening and mechanisms of DIHS and DIPL, and review specific examples of drugs commonly used in clinical practice that are known to cause DIHS.

Keywords

drug-induced hepatic steatosis - drug-induced steatohepatitis
 

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