Drug-Induced Cholestasis

Medications and herbal supplements can induce a variety of hepatic, acute, and chronic cholestatic syndromes including bland cholestasis, cholestasis with concurrent hepatitis, bile duct injury, and extrahepatic biliary strictures and stones. Most cases of drug- and herbal-induced cholestasis are benign, but progression to chronic liver disease, cirrhosis, and death is well described. We discuss the different types of cholestasis that can be induced by medications and herbal supplements and the mechanisms of cholestasis caused by medications. We also provide some insights into treatment. In addition, specific examples of medications and herbal supplements that are known to cause one of the cholestatic syndromes are provided.