Drugs which may interfere with bilirubin levels

Some drugs may interfere with the bilirubin level. Plasmatic bilirubin is generally associated with albumin, thanks to specific binding sites. Some drugs may compete for these binding sites, therefore indirectly increasing the level of unbound bilirubin in the blood. As a conseguence the bilirubin/albumin molar ratio may change with an increased risk of development of kernicterus (see here for more on bili/alb molar ratio). In facts, the complex bilirubin-albumin is not able to cross the hematoencephalic barrier; on the contrary, unbound bilirubin may cross the hematoencephalic barrier. In other words, if the serum level of bilirubin exceeds the binding capacity of albumin, the lipid-soluble free bilirubin crosses the blood-brain barrier, causing a neurologic condition referred as kernicterus.

Schematic view of the mode of action of bilirubin-albumin displacing drugs (from Strauss et al.)

The following table (from http://micromedex.hcn.net.au/mdx-29191/ddl45.htm) is a list of drugs which may interfere with the bilirubin level. Consider it as a reminder to always ask you physician or pharmacist before assuming any drug to check if it is right for you. For more infos on potential bilirubin-albumin displacing drugs see also appendix in Strauss et al. 2006



From: http://micromedex.hcn.net.au/mdx-29191/ddl45.htm

Links from: http://www.nlm.nih.gov/medlineplus/druginformation.html