Drugs and toxins that cause acute liver failure

(nearly 80% of cases in U.S.; Gastro 2015;148:1353, Clin Liver Dis 2017;21:151)

Dose-dependent: acetaminophen (most common cause; >40% of cases in U.S.)

Idiosyncratic, not dose related: anti-TB drugs (INH, RIF, PZA); AEDs (phenytoin, valproate, carbamazepine); NSAIDs; abx (eg, fluoroquinolones, macrolides, nitro-furantoin); drugs of abuse (MDMA & cocaine); others (amiodarone, TCAs)

Toxins: Amanita phalloides (mushroom sp. in West Coast), certain herbal preparations