Drug-Induced Liver Injury: Hepatotoxicity and Treatment – A Literature Review

Year : 2026 | Volume : 16 | Issue : 01 | Page : 1 17
    By

    Shruti Patel,

  • Kris Kapadiya,

  1. Researcher, Department of Pharmacy, Gujarat Technological University, School of Pharmacy, Nr. Government Polytechnic K-6 Circle, Gujarat, India
  2. Researcher, Department of Pharmacy, Gujarat Technological University, School of Pharmacy, Nr. Government Polytechnic K-6 Circle, Gujarat, India

Abstract

Drug-induced liver injury (DILI) is a major clinical and regulatory challenge, posing risks to patient safety and drug development worldwide. As the primary organ responsible for xenobiotic metabolism, the liver is particularly susceptible to toxic injury from prescription drugs, over-the-counter medications, herbal products, and dietary supplements. Drug-induced liver injury (DILI) accounts for a substantial proportion of acute liver failure cases and remains a leading cause of post-marketing drug withdrawal. Its pathophysiology is multifactorial, involving mitochondrial dysfunction, oxidative stress, immune-mediated injury, and genetic predispositions. Risk factors such as age, gender, polypharmacy, comorbidities, and environmental influences further complicate susceptibility. Diagnosis relies on a combination of clinical suspicion, liver function tests, imaging, histopathology, and causality assessment tools such as RUCAM, though limitations persist. Biomarkers including miR-122, cytokeratin-18, and HMGB1 show promise for early detection, but require validation. Current management strategies focus on early withdrawal of the offending agent, supportive care, and in severe cases, liver transplantation. Specific antidotes such as N-acetylcysteine are effective for acetaminophen toxicity, while herbal agents like silymarin and curcumin are under investigation for hepatoprotective effects. Preventive strategies emphasize pharmacogenomics, monitoring, and personalized medicine approaches. Emerging technologies, including omics platforms, advanced in vitro and in vivo models, and artificial intelligence-driven predictive tools, offer opportunities for better risk assessment and therapeutic innovation. This review highlights the complexity of DILI, summarizes current diagnostic and therapeutic strategies, and emphasizes the need for future research in biomarker development and personalized prevention to improve patient safety and optimize drug development.

Keywords: Drug-induced liver injury (DILI), acute liver failure, xenobiotic metabolism, hepatotoxicity, mitochondrial dysfunction, oxidative stress.

[This article belongs to Research and Reviews: A Journal of Toxicology ]

How to cite this article:
Shruti Patel, Kris Kapadiya. Drug-Induced Liver Injury: Hepatotoxicity and Treatment – A Literature Review. Research and Reviews: A Journal of Toxicology. 2025; 16(01):1-17.
How to cite this URL:
Shruti Patel, Kris Kapadiya. Drug-Induced Liver Injury: Hepatotoxicity and Treatment – A Literature Review. Research and Reviews: A Journal of Toxicology. 2025; 16(01):1-17. Available from: https://journals.stmjournals.com/rrjot/article=2025/view=234353


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Regular Issue Subscription Review Article
Volume 16
Issue 01
Received 05/10/2025
Accepted 04/12/2025
Published 15/12/2025
Publication Time 71 Days
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