Cocaine-induced hepatotoxicity is well known in animal models, and many cases of it have been reported in human beings. We reviewed the results of liver function tests perfomed on admission in 71 randomly selected hospitalized nonparenteral cocaine abusers. We found 11 patients to have elevated levels of aspartate aminotransferase that were less than 28 U above the upper limit of normal. Five of them also had elevated levels of alanine aminotransferase that were less than 12 U above the upper limit of normal. Two patients had isolated elevations in alanine aminotransferase (<9 U above the upper limit of normal), and two patients had elevations in alkaline phosphatase (<50 U above the upper limit of normal). There was no correlation with regard to age, sex, duration of drug use, last dose, amount of use, or timing of blood tests. This minimal elevation of liver enzyme levels is common, but severe hepatotoxicity is uncommon.
(Arch Intern Med. 1991;151:1126-1128)