Hepatotoxicity

Hepatotoxicity is chemical injury to the liver caused by a drug, supplement, herb, or other substance, ranging from mild enzyme elevation to serious liver failure.

The liver metabolizes most foreign compounds, which makes it the organ most exposed to their byproducts. Injury is usually detected first through blood tests showing rises in enzymes such as ALT and AST, sometimes with elevated bilirubin. Many cases are silent; others produce fatigue, nausea, abdominal discomfort, dark urine, or jaundice. Assessment involves stopping the suspected cause, repeating blood tests, and excluding viral hepatitis and other explanations.

Clinical trials of prescription cannabidiol recorded liver enzyme elevations in a minority of participants, more often at higher doses and in people also taking valproate, and the prescribing information calls for baseline and periodic liver tests. Retail products deliver much smaller amounts, and data on their hepatic effects are limited. The U.S. Food and Drug Administration has cited liver injury as a safety concern in its consumer communications. Anyone with liver disease or on hepatically metabolized medications is generally advised to consult a clinician before using cannabinoids.