10 Medications That Can Harm the Liver

Your liver works hard to keep your body healthy, but certain medications may put it at risk

Goldina Erowele,

Updated July 20, 2026

AARP

Reviewed by

Merle Myerson, M.D. and Zachary Cox, PharmD

Comments

En español

Updated July 20, 2026

illustration of pills pouring out on an anatomical drawing

Pete Ryan

Key takeaways

Some common medications and supplements can damage the liver, especially when misused or combined.
Risk rises with higher doses, long-term use, alcohol or taking multiple medications.
Monitoring, following directions and consulting providers can help reduce liver injury risk.

Your liver is one of the hardest-working organs in your body. It cleans your blood, helps digest food and keeps you healthy. But did you know that some common medications can make your liver sick?

It’s a condition known as drug-induced liver injury, explains Dr. Udoka Ikezuagu, a hospitalist at Loma Linda University Medical Center in Murrieta, California. And while most medications are safe when taken as directed, older adults can be more sensitive to these risks, so it’s important to be aware and bring any concerns to your health care provider.

Older individuals are also more likely to take multiple medications — more than 40 percent of people 65 and older regularly take five or more prescription drugs, a Lown Institute report found — raising the risk of stress and damage to the liver.

Signs of drug-induced liver injury

Jaundice (yellowing of the skin or eyes)
Dark urine
Pale stools
Fatigue
Nausea or loss of appetite
Pain or swelling in the abdomen
Itchy skin
Confusion

Keep in mind: Symptoms don’t always appear right away. If you think you have drug-induced liver damage, the FDA recommends getting medical help immediately since early treatment is more effective. Call 911 or Poison Control (800-222-1222).

Here are 10 medications that in some instances can hurt the liver, plus ways to help protect it from damage.

1. Acetaminophen

What it is: Acetaminophen (a.k.a., paracetamol, internationally) is a popular over-the-counter medication for treating mild to moderate pain and reducing fever.

Common name: Tylenol

How it affects the liver: Acetaminophen is safe if you follow the directions and take the recommended amount, but it’s easy to overdo it, since it’s found in many combination medications, such as cold and flu remedies. Taking too much acetaminophen for a headache or muscle ache can be hard on your liver and cause harm. This risk goes up if you drink alcohol or already have a history of liver problems.

Tips to lower your risk of injury: Always follow the label and don’t take more than the recommended amount. (According to the manufacturer, the daily dose limit is 3,250 milligrams or adults. However, some doctors may allow up to 4,000 milligrams per day, the U.S. Food and Drug Administration’s maximum recommended amount.) Be sure to read the list of ingredients on all OTC medications and talk to your health care provider or pharmacist before using acetaminophen if you drink alcohol or have liver problems.

2. Statins

What they are: Statins are prescription medications that lower cholesterol levels and the risk of heart disease.

Common names: atorvastatin (Lipitor), simvastatin (Zocor), rosuvastatin (Crestor)

How they affect the liver: While generally safe and well tolerated, statins can cause mild, usually temporary increases in liver enzymes, in particular alanine aminotransferase (ALT) and aspartate aminotransferase (AST). However, increases of less than three times the upper limit of normal may not require your doctor to stop statin use. And enzyme levels go back to normal once you stop the medication. In rare cases, they can cause serious liver problems, especially if you already have issues with your liver.

Tips to lower your risk of injury: Before you start a statin, your health care provider may order blood tests to measure your liver enzymes. Additional testing is generally recommended only if you develop symptoms or if there’s another medical reason to check your liver. Common blood tests to check liver function include ALT, AST, alkaline phosphatase (ALP) and bilirubin.

3. Amoxicillin-clavulanate

What it is: Amoxicillin-clavulanate, an antibiotic, treats a variety of bacterial infections.

Common name: Augmentin

Ask your pharmacist

Starting a new med? Whether it’s prescribed by your doctor or bought over the counter, here’s a checklist of questions to ask:

Will this medication cause interactions with my other medications or medical conditions?
What side effects should I expect?
Should I take this at a particular time of day?
Should it be taken with food?

How it affects the liver: Amoxicillin-clavulanate can sometimes harm the liver. Though the exact cause is unclear, research suggests it’s likely due to an allergic reaction caused by clavulanate. Liver problems can occur a few days to weeks after starting the medicine or even after finishing it. The risk increases with prolonged use and existing liver problems.

Tips to lower your risk of injury: It’s always important to make your health care provider aware of all medicines you are currently taking, but it’s especially important if taking amoxicillin-clavulanate, as it can interact with a number of medicines.

4. Antiseizure medications

What they are: These medications are used to prevent and treat seizures and certain types of nerve pain.

Common names: phenytoin (Dilantin), carbamazepine (Tegretol)

How they affect the liver: Antiseizure medications such as phenytoin (Dilantin) and carbamazepine (Tegretol) can prompt an abnormal immune response in the liver, sometimes called hypersensitivity syndrome, which can damage nearby tissues. Medications like valproic acid (Depakene) and lamotrigine (Lamictal), can also affect the liver. Liver injury may appear within days to months after starting treatment and can be severe in rare cases.

Tips to lower your risk of injury: If you are prescribed these medications, your health care provider may perform blood tests to check your liver health. Depending on test results, they may adjust your dose or switch you to a different medication.

5. Methotrexate

What it is: Methotrexate is a prescription drug used to treat rheumatoid arthritis, certain cancers and autoimmune diseases.

Common names: Trexall, Rheumatrex

How it affects the liver: Methotrexate can harm the liver, especially if taken for a long time or at high doses. (People taking the drug short-term may not be affected.) It may cause liver inflammation and, over time, lead to scarring (fibrosis) or serious liver disease (cirrhosis). The risk increases if you drink alcohol or already have liver problems.

Tips to lower your risk of injury: If this is prescribed, your health care provider may test your liver with blood work and adjust your medication if needed. Discuss your treatment plan with your doctor, and avoid alcohol while taking this medication.

6. Nonsteroidal anti-inflammatory drugs (NSAIDs)

What they are: NSAIDs are OTC medications used to treat pain, inflammation and fever.

Common names: ibuprofen (Advil, Motrin), naproxen (Aleve), diclofenac (Voltaren)

How they affect the liver: NSAIDs are usually safe for short-term use at recommended doses. However, taking them for a long time, at higher doses or combining with alcohol can put stress on the liver and, in some cases, cause liver damage. People with liver conditions or those taking multiple medications that affect liver function are at higher risk.

Tips to lower your risk of injury: Before using NSAIDs, check with your health care provider. They may recommend starting with the lowest dose for the shortest time or may suggest an alternative.

7. Certain herbal and dietary supplements

What they are: Herbal and dietary supplements are often marketed for various health benefits, but some can cause damage to the liver. Kava and black cohosh are two examples.

Common names: kava (Piper methysticum), black cohosh (Cimicifuga racemosa)

How they affect the liver: Kava is used for anxiety and insomnia and has been associated with rare but potentially serious liver damage, though the exact cause is unclear. Black cohosh, often used for menopause symptoms, has been linked to liver problems such as a rise in liver enzymes and liver failure. Dozens of cases of liver injury linked to these supplements have been reported in the U.S.

Because the FDA does not regulate or approve herbal or dietary supplements in the same way it does other medications, ingredients in marketed products can vary, and some may contain harmful substances.

Tips to lower your risk of injury: Be a savvy consumer and know that “natural” doesn’t always mean safe. Always talk to your doctor before using supplements, and avoid using these supplements if you have existing liver problems.

8. Antifungal medications

What they are: Antifungals are a class of medications used to treat fungal infections in the skin, lungs and nails.

Common names: fluconazole (Diflucan), itraconazole (Sporanox), oral ketoconazole (Nizoral)

How they affect the liver: Antifungal medications can damage the liver, particularly when used for a longer duration. When prescribed for short-term use for conditions like yeast infections, they are not as likely to cause harm. However, the length of time you take the medicine doesn’t reliably predict risk. The effects can range from a mild rise in liver enzymes (which is generally not concerning and can be monitored) to inflammation and even liver failure in rare cases.

Tips to lower your risk of injury: Your doctor may recommend baseline liver function tests before starting systemic (oral) antifungal medications, based upon the duration of therapy. Talk to your doctor about all other medications you’re taking.

9. Amiodarone

What it is: Amiodarone is a prescription medication for treating and preventing life-threatening irregular heartbeats (arrhythmias).

Common names: Cordarone, Pacerone

How it affects the liver: Amiodarone can damage the liver, affecting up to 1 percent of people who take it every year. It can raise liver enzyme levels or, in rare cases, lead to liver scarring. The FDA has issued a boxed warning about the risk of liver injury with this medication.

Tips to lower your risk of injury: Your health care provider will check liver enzyme levels before starting the medication and during treatment.

10. Isoniazid

What it is: Isoniazid is an antibiotic used for treating tuberculosis and, in some cases, preventing it.

Common names: INH, Nydrazid

How it affects the liver: Isoniazid is broken down by the liver and can cause liver damage. It causes mild inflammation to serious liver injury — especially in older adults, those with liver conditions or those who drink alcohol. It also has an FDA boxed warning about liver inflammation risk, particularly when combined with certain medications.

Tips to lower your risk of injury: Your health care provider may check the health of your liver with lab tests, especially if you have risk factors for liver disease.

Risk factors for liver damage

Some factors can raise the risk of liver damage from medications, including:

A history of liver issues
Frequent alcohol use
Taking multiple medications

Working closely with your health care provider and pharmacist can help protect your liver. They may check your liver health and adjust your treatment if needed, says Jessica Njoku, medical science liaison at AstraZeneca and formerly a pharmacist with Harris Health System in Houston.

To help protect your liver, take your medications exactly as prescribed, Ikezuagu says, and never change your dose without talking to your health care provider first. What’s more, be sure to talk to your doctor before mixing prescription drugs, OTC medications and supplements.

%{postComment}%

The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.

Goldina Erowele, PharmD, is a clinical pharmacy executive and healthcare consultant specializing in medical communications, clinical strategy and solutions.

Dr. Merle Myerson is a board-certified cardiologist with specialties in sports medicine, lipids, women’s health and prevention of cardiovascular disease.

Zachary Cox is a pharmacist and professor at Lipscomb University College of Pharmacy and adjunct professor at Vanderbilt University School of Medicine in Nashville, Tennessee.