Yellow eyes, medically known as scleral icterus, indicate an underlying health concern. This yellow discoloration of the white part of the eyes often points to a disruption in the body’s processes. While various medical conditions can cause this, certain medications can also induce yellow eyes. This article explores how specific drugs cause this and what steps to take if you notice this symptom.
Understanding Yellow Eyes
Yellow eyes, or jaundice, occur due to an accumulation of bilirubin in the body’s tissues. Bilirubin is a yellow pigment that forms when old or damaged red blood cells break down.
Once formed, bilirubin travels through the bloodstream to the liver. The liver processes this bilirubin, converting it into a water-soluble form (conjugated bilirubin) for elimination. This conjugated bilirubin is then excreted into bile, moving through bile ducts into the digestive tract and eventually removed in stool. When this process is disrupted, bilirubin levels rise, leading to the characteristic yellowing of the skin and eyes.
Mechanisms of Drug-Induced Yellow Eyes
Drugs can cause yellow eyes by interfering with bilirubin metabolism or liver function. One way is hepatocellular injury, where medications directly damage liver cells. This impairs the liver’s ability to process and excrete bilirubin, leading to its buildup in the bloodstream.
Another mechanism is cholestasis, which involves the disruption of bile flow from the liver. Drugs can block or slow bile movement through the bile ducts, causing bilirubin to back up within the liver and enter the general circulation. This leads to an accumulation of conjugated bilirubin.
Some drugs can induce hemolysis, the premature breakdown of red blood cells. When red blood cells are destroyed at an accelerated rate, large amounts of bilirubin are produced, overwhelming the liver’s capacity to process it. This excess unconjugated bilirubin then accumulates, resulting in yellow eyes.
Drug Categories Associated with Yellow Eyes
Several categories of medications are known to cause drug-induced jaundice, often impacting liver function or bilirubin processing. Antibiotics are a common group, with examples like amoxicillin/clavulanate and erythromycin frequently implicated, often causing cholestatic or hepatocellular injury. Amoxicillin/clavulanate is a leading cause of drug-induced liver injury, with symptoms sometimes appearing weeks after treatment ends.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can lead to liver toxicity and jaundice, primarily through hepatocellular injury. Some NSAIDs, like sulindac and diclofenac, are more frequently associated with liver damage.
Antifungals, including ketoconazole and fluconazole, can cause liver injury, typically involving hepatocellular damage or cholestasis. Ketoconazole has a higher incidence of hepatic damage compared to other systemic antifungals.
Statins, cholesterol-lowering drugs like simvastatin and atorvastatin, can occasionally cause liver enzyme elevations and, rarely, liver injury leading to jaundice. This risk is generally low, but cases of cholestatic hepatitis have been reported.
Antiepileptic drugs, such as valproic acid and phenytoin, are associated with liver toxicity, predominantly through hepatocellular injury. Valproic acid requires regular monitoring of liver function.
Beyond prescription medications, certain herbal supplements and over-the-counter remedies have been linked to liver injury and yellow eyes. Examples include green tea extract, turmeric, kava kava, and some multi-ingredient weight loss supplements. The unregulated nature of these products means the exact amount of active chemicals is often unknown, increasing the risk of liver toxicity.
When to Seek Medical Attention
Noticing yellow eyes warrants prompt medical evaluation. It signifies an underlying issue with bilirubin processing or liver function, regardless of whether medication is suspected. Contact your doctor or seek urgent care immediately if you observe yellowing of your eyes or skin.
A healthcare professional can perform tests to determine the cause of jaundice and recommend treatment. Inform your doctor about all medications, including over-the-counter drugs, supplements, and herbal remedies. This information is important for accurate diagnosis and management. Other symptoms that may accompany yellow eyes and require immediate medical attention include dark urine, pale stools, fatigue, nausea, vomiting, or abdominal pain.