What Medications Lead to Jaundice?

October 12, 2025 •

3 min read

Drug-induced liver injury (DILI) accounts for up to 7% of all reported adverse drug effects, with jaundice being a potential symptom. Discover what medications lead to jaundice and the different mechanisms behind this serious side effect.

Quick Summary

Various medications, from antibiotics to pain relievers, can cause jaundice by damaging liver cells, blocking bile flow, or destroying red blood cells. Risk factors include genetics, age, and existing liver conditions, necessitating careful monitoring.

Key Points

Drug-Induced Liver Injury (DILI): Jaundice is a key sign of DILI, a potentially serious side effect where medications harm the liver.
Multiple Mechanisms of Action: Jaundice can be caused by medications through direct liver cell damage (hepatocellular injury), blocked bile flow (cholestasis), or red blood cell destruction (hemolysis).
Common Culprits: Frequently prescribed antibiotics (e.g., amoxicillin-clavulanate), pain relievers (e.g., acetaminophen overdose), and statins are among the many drugs associated with jaundice.
Individual Risk Factors: An individual's risk is influenced by age, gender, genetic predispositions, and underlying liver conditions.
Immediate Medical Evaluation is Crucial: Any yellowing of the skin or eyes while on medication warrants prompt medical attention and potential discontinuation of the drug under a doctor's supervision.
Comprehensive Drug History: It is essential to inform your healthcare provider about all medications, including OTCs and supplements, to identify the causative agent.

Jaundice is the yellowing of the skin and eyes caused by high levels of bilirubin in the blood. While it is most commonly associated with liver diseases like hepatitis, it can also be a significant side effect of various medications. This condition, known as drug-induced liver injury (DILI), can occur through several mechanisms, ranging from predictable dose-dependent toxicity to rare, idiosyncratic reactions. For healthcare providers and patients alike, understanding the drugs and underlying processes involved is crucial for prevention, diagnosis, and appropriate management.

The Mechanisms of Drug-Induced Jaundice

Medications can induce jaundice in several ways, primarily by interfering with the liver's normal function in processing and eliminating bilirubin. The main mechanisms include:

Hepatocellular Injury

This involves direct damage to the liver cells (hepatocytes), impairing their ability to process bilirubin from the bloodstream. This can be dose-dependent, as with acetaminophen overdose, or unpredictable (idiosyncratic).

Cholestatic Injury

This occurs when bile flow from the liver is blocked, leading to an increase in conjugated bilirubin and jaundice. This is often due to idiosyncratic, immune-mediated reactions.

Hemolytic Anemia

In rare cases, a medication can cause the premature destruction of red blood cells, overwhelming the liver's ability to process the released bilirubin and causing jaundice.

Key Medication Classes Linked to Jaundice

Many different types of drugs can cause drug-induced liver injury and jaundice. Some commonly implicated classes and examples are:

Antibiotics: A leading cause of DILI. Amoxicillin-clavulanate, flucloxacillin, sulfonamides, erythromycin, and tetracyclines are linked to often-delayed cholestatic reactions.
Pain Relievers (NSAIDs and Acetaminophen): Overdosing on acetaminophen is a major cause of acute liver failure and hepatocellular jaundice. Other pain relievers can also cause idiosyncratic liver injury.
Statins: Cholesterol-lowering drugs can cause liver injury.
Antituberculosis Medications: Some antituberculosis drugs are known for hepatotoxicity.
Anabolic Steroids and Hormones: These can cause cholestatic jaundice, particularly with prolonged use.
Psychotropic Drugs: Some psychotropic drugs have been linked to jaundice.
Anticonvulsants: Certain anticonvulsant drugs are associated with liver injury.

Risk Factors for Drug-Induced Jaundice

Individual susceptibility to drug-induced jaundice varies due to several factors including age, gender, genetic factors, underlying liver conditions, and the dose and duration of medication.

Comparison of Medication Classes and Jaundice Type


Drug Class	Example Drugs	Primary Mechanism	Jaundice Type	Notes
Antibiotics	Amoxicillin-clavulanate, Flucloxacillin, Sulfonamides	Idiosyncratic, immune-mediated	Cholestatic	Often delayed onset, can be protracted
Pain Relievers (NSAIDs)	Diclofenac, Ibuprofen	Idiosyncratic	Cholestatic, Hepatocellular	Unpredictable reactions
Pain Relievers (Acetaminophen)	Acetaminophen	Dose-dependent toxicity	Hepatocellular	Overdose causes severe liver necrosis
Statins	Atorvastatin, Simvastatin	Idiosyncratic, metabolic	Cholestatic, Mixed	Rare, but monitor liver function
Antituberculosis Drugs	Isoniazid, Rifampin	Idiosyncratic, toxic metabolites	Hepatocellular	Risk is higher with age and alcohol use
Anabolic Steroids	Various	Direct toxicity	Cholestatic (bland)	Can cause prolonged jaundice
Psychotropic Drugs	Chlorpromazine, Tricyclic Antidepressants	Idiosyncratic, hypersensitivity	Cholestatic	Classic example, can lead to chronic issues

What to Do If You Suspect Drug-Induced Jaundice

If you notice symptoms like yellow skin or eyes while on medication, contact a healthcare provider immediately. Do not stop medication independently and provide a full medication history, including OTCs and herbals. Follow medical advice and seek supportive care; specific antidotes exist for acetaminophen overdose.

Conclusion

Drug-induced liver injury, marked by jaundice, is a potential concern with many medications, including antibiotics, acetaminophen, and statins. It can result from liver cell damage or bile flow obstruction. Recognizing risk factors and symptoms and seeking prompt medical advice are crucial. Resources like the LiverTox database provide valuable information for healthcare providers {Link: NCBI Bookshelf https://www.ncbi.nlm.nih.gov/books/NBK557535/}.

Frequently Asked Questions

The onset can vary widely depending on the drug. Some reactions can occur within days or weeks of starting a medication, while others, like those caused by amoxicillin-clavulanate, may not appear until several weeks after treatment has finished.

Yes, taking too much acetaminophen, especially in an overdose situation, is a leading cause of acute liver failure and severe jaundice. Symptoms can take days to appear, and severe cases can be fatal or require a liver transplant.

Other symptoms can include yellowing of the whites of the eyes (scleral icterus), dark urine, pale stools, fatigue, nausea, vomiting, itching, and pain in the upper right abdomen.

Yes. Herbal products and dietary supplements are a documented cause of liver injury and can lead to jaundice. Examples include some traditional Chinese medicines, greater celandine, and chaparral.

Hepatocellular jaundice results from direct damage to liver cells, preventing them from processing bilirubin effectively. Cholestatic jaundice is caused by a blockage in the flow of bile, leading to an accumulation of conjugated bilirubin.

You should contact your healthcare provider immediately. Do not stop taking your medication on your own. A doctor will need to evaluate your symptoms, possibly perform tests, and determine if the medication is the cause before advising on next steps.

Yes, factors such as age, gender, genetic predispositions (certain HLA types), and having pre-existing liver conditions can increase the risk of developing drug-induced jaundice.

In most cases, if the offending drug is identified and discontinued promptly, the jaundice is reversible and liver function returns to normal. However, severe or chronic cases can lead to lasting liver damage.