Back to basics for idiosyncratic drug-induced liver injury: dose and metabolism make the poison.
Two studies show that the risk of drug-induced liver injury (DILI) is increased when the daily dose of a drug given by oral route is higher than 10mg per day and/or when the drug undergoes a significant hepatic metabolism. If confirmed, these data suggest that developing drugs with high potency and low hepatic metabolism will reduce the risk of idiosyncratic DILI in man.
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Sanofi-aventis R&D, 91385 Chilly-Mazarin, France. francois.ballet@sanofi-aventis.com