What medications are hard on the liver?

The commonest drug-induced liver injury comes from a medicine people think of as harmless: acetaminophen. MedlinePlus says painkillers and fever reducers containing acetaminophen are a common cause of liver injury, particularly when taken in doses greater than those recommended, and that people who drink alcohol to excess are more likely to have this problem. The trap is arithmetic: acetaminophen hides in cold and flu combos, sleep aids, and prescription painkillers, so people double-dose without realizing, and the daily maximum exists because the liver's processing pathway saturates. The wider list: some antibiotics, anti-seizure drugs, high-dose niacin, anabolic steroids, certain herbal supplements, and green tea extract concentrates among them. The good news in the MedlinePlus guidance: the primary treatment is to stop taking the medicine that caused the problem, and most drug-induced liver injury heals once the drug is withdrawn, though high-dose acetaminophen overdoses are emergency-department territory because a specific antidote exists and timing matters. Protecting your liver: respect the acetaminophen daily maximum and count every product containing it; be honest about alcohol when prescribed anything liver-metabolized; report the warning cluster, nausea, dark urine, yellowing eyes, right-upper-abdomen pain, promptly when on a flagged drug; and ask whether monitoring blood tests make sense for long-term drugs with liver reputations.