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Drug-induced jaundice
Other Resources UpToDate PubMed

Drug-induced jaundice

Contributors: Michael W. Winter MD, Paritosh Prasad MD
Other Resources UpToDate PubMed


Jaundice is a yellowing of the skin, mucous membranes, and sclera of the eyes. It is caused by accumulation of bilirubin in these organs. Bilirubin may accumulate due to increased release into the blood or decreased clearance into feces and urine. Hemolysis is the most common cause of increased release into blood, while hepatic and biliary dysfunction are the most common causes of decreased clearance. Drugs may induce jaundice through any of these mechanisms.

Some drugs may induce hemolysis, leading to increased circulating bilirubin. Other drugs can cause hepatotoxicity, leading to hepatocellular damage and subsequent decreased bilirubin conjugation by the liver. Finally, drugs may induce cholestasis or bile duct injury, decreasing excretion of bilirubin. Many prescription medications, illicit drugs, and over-the-counter supplements, either at typical doses or overdoses, have been associated with jaundice from a variety of mechanisms of liver injury.

The hallmark symptom of drug-induced jaundice will be yellowing of the skin. This can occur in the setting of an otherwise asymptomatic patient, or in a patient with sequelae of hepatitis and even liver failure, marked by altered mental status, coagulopathy, and fatigue. Some patients with hyperbilirubinemia will report pruritus.


R17 – Unspecified jaundice

18165001 – Jaundice

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Hemolytic anemia
  • Gilbert disease
  • Crigler-Najjar syndrome
  • Dubin-Johnson syndrome
  • Rotor syndrome
  • Choledocholithiasis
  • Pancreatic carcinoma (and other pancreatic cancers)
  • Cholangiocarcinoma (and other pancreaticobiliary malignancies)
  • Acute ascending Cholangitis
  • Primary sclerosing cholangitis
  • Primary biliary cholangitis
  • Hepatocellular carcinoma
  • Liver cirrhosis
  • Acute or chronic hepatitis (eg, Hepatitis A virus infectionHepatitis B virus infectionHepatitis C virus infection)
  • Cholestasis of pregnancy
  • Acute fatty liver of pregnancy
  • HELLP syndrome
  • Bacterial sepsis
  • Wilson disease
  • Celiac disease with microvesicular / macrovesicular liver injury
  • Autoimmune hepatitis
  • Acute Alcoholic hepatitis
  • Hypothyroidism with subsequent liver injury
  • Hemochromatosis

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:08/09/2018
Last Updated:07/18/2019
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Drug-induced jaundice
A medical illustration showing key findings of Drug-induced jaundice : Jaundice
Clinical image of Drug-induced jaundice - imageId=2808199. Click to open in gallery.  caption: 'Deep yellow color of the sclerae.'
Deep yellow color of the sclerae.
Copyright © 2024 VisualDx®. All rights reserved.