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.