ABSTRACT
Nonsteroidal anti-inflammatory drugs (NSAIDs) as a class are an important cause of drug-
induced toxic injury to several organ systems, includingwell-known injury to the gastrointestinal
tract and kidneys, and more recently, cardiac toxicity associated with rofecoxib (Vioxx) and
other COX-2 inhibitors (1). While perhaps less well appreciated, NSAIDs are a leading cause of
drug-induced hepatotoxicity. For instance, in Denmark, NSAIDs accounted for approximately
9% (97 of 1100) of all drug-related liver injury reports between 1978 and 1987 (2) and they
continue to be reported at a rate that often exceeds other drug classes (3). A number of NSAIDs
are listed among drugs causing fulminant hepatic failure (FHF) (4,5), occasionally leading to
emergency liver transplantation (6,7).
