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Liver Update: Drug-induced liver injury in older adults

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eMediNexus    21 October 2021

Drug-induced liver injury (DILI) stands as a leading cause of hospitalisation and medication deregistration. 

The increasing size of the elderly population coupled with the increasing prevalence of age-related disease, have further increased the consumption of medications by this section of the population. However, the susceptibility of older people to adverse events and drug-induced liver disease is extremely variable and different from that of younger counterparts. 

The elderly are susceptible to DILI due to changes in physiology and increased interindividual variability, intensified by an increased prevalence of disease and the frailty syndrome. 

The risks of DILI, particularly serious hepatotoxicity in the elderly should be explored with the help of Rigorous pharmacovigilance studies. 

A systematic approach is warranted to determine the hepatotoxic drugs and they should be then removed from the market. Also, it is important to determine the hepatotoxicity risks from marketed drugs to consumers with different characteristics, especially older people.

Thus understanding hepatic clearance, the mechanisms and risks of DILI in the elderly will help in evidence-based prescribing for this population, benefitting as reduced risk of adverse drug reactions and DILI, and improved quality use of medicines in older people.

Source: Mitchell SJ, Hilmer SN. Drug-induced liver injury in older adults. Therapeutic Advances in Drug Safety. December 2010:65-77. doi:10.1177/2042098610386281

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