Even damaged livers can handle medicines for diabetes, Blood Pressure

New York People with diabetes, hypertension and depression might be able to continue taking life saving medications in small doses even while they heal from drug-induced liver injuries, suggests new research. The findings, published in the journal Drug Metabolism and Disposition, suggests that doctors need not always make patients with drug-induced liver injury stop taking all their medications until the liver healed.

Drug-induced liver injury -- when a person accidentally harms their liver by taking medications prescribed by a doctor (or occasionally over the counter drugs) -- affects about almost 1 million people globally. "Doctors give patients drugs to treat diseases. No one wants their liver damaged, but it happens all the time," said Xiaobo Zhong from the University of Connecticut in the US.

When a person takes a medication by mouth, it goes into their stomach and then to the intestines, where it is absorbed into the blood. This blood, in turn, passes first through the liver before reaching the rest of the body. The liver has enzymes that break down medicines. But different people naturally have more or less of these enzymes. Sometimes, what could be a safe and effective dose in one person is too much for someone else who has different enzyme

levels.

This is why some individuals are more vulnerable to liver damage, even when taking drugs just as a doctor prescribed. There is no standard guidance for doctors when a patient gets drug-induced liver damage. Often times they tell the person to stop taking all medications immediately and wait for their liver to recover. But that can take weeks or months.

"But if patients have chronic conditions such as diabetes, hypertension, or depression, their conditions can run out of control," if they stop taking the medications, Zhong said.

And that can be life threatening. The researchers tested whether mice whose livers had been damaged by acetaminophen (the active ingredient in Tylenol) had lower levels of drug metabolising enzymes, called cytochrome P450 enzymes. The researchers investigated whether mice with drug-induced liver damage can

safely take medications for diabetes, hypertension and depression.

It looks like they can, as long as the doses are much smaller than normal, said the study. Because the damaged liver does not break down the medications as efficiently, they are just as effective at these lower doses. The team still has to test whether these results hold in humans.