It can also lower the number of platelets, which are necessary for proper blood clotting. If you become pregnant while taking methimazole, call your doctor immediately. Both drug; she was reluctant to other types of therapy, not diseases are more common in females and in younger visiting endocrinologist regularly. Symptoms of Methimazole Allergy in Cats Since some of these symptoms (vomiting, weight loss, weakness) are also signs of hyperthyroidism, you may not notice them right away. Do not keep outdated medicine or medicine no longer needed. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. 2021 Jan 29;16(1):e0245978. A normal thyroid hypoechogenicity score at withdrawal of MMI had a higher specificity (0.95) and sensitivity (0.59) with respect to TRAb values (0.86 and 0.53, respectively) for the prediction of the relapse of hyperthyroidism at the 24th month. Total daily dose may be given as a single dose or in 2 divided doses (for doses >30 mg/day) (Burch 2015; Ross 2016). Comparison of methimazole and propylthiouracil in the management of children and adolescents with Graves' disease: efficacy and adverse reactions during initial treatment and long-term outcome. This medicine works best when there is a constant amount in the blood. Adverse effects of hormones and hormone antagonists on the liver. Kontoleon P, Ilias I, Koutras DA, Kontogiannis D, Papapetrou PD. The fentanyl withdrawal timeline begins quickly. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. Please enable it to take advantage of the complete set of features! [. Usefulness of Measuring Thyroid Stimulating Antibody at the Time of Antithyroid Drug Withdrawal for Predicting Relapse of Graves Disease. Longitudinal prospective study of previously untreated patients with GD. You may report side effects to the FDA at 1-800-FDA-1088. Zhang M, Zhou H, He R, Di F, Yang L, Yang T. Steroids for the treatment of methimazole-induced severe cholestatic jaundice in a 74-year-old woman with type 2 diabetes. The patient was ill for almost two months but recovery was otherwise uncomplicated. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Suzuki N, Noh JY, Hiruma M, Kawaguchi A, Morisaki M, Ohye H, Suzuki M, et al. Your experience with methadone withdrawal will depend on a variety of factors, including your past experiences and expectations. Methimazole is used to treat hyperthyroidism, a condition that occurs when the thyroid gland produces too much thyroid hormone. Amsterdam: Elsevier, 2013, pp. 2006 Mar;16(3):295-302. doi: 10.1089/thy.2006.16.295. Patients: The medication methimazole works by preventing the thyroid gland from making too much thyroid hormone. Verywell Mind's content is for informational and educational purposes only. A. difficulty in moving. low blood counts due to bone marrow failure. Here in this paper, we report a 31-year-old case admitted with symptoms of hyperthyroidism that was then diagnosed with Grave's disease (GD) and underwent treatments with a low dosage of methimazole (10 mg/day). Make sure you tell your doctor if you have any other medical problems, especially: Take this medicine only as directed by your doctor. average of thyroid weight 68g) who have been treated by MMI for 1 to 6 years were enrolled. Results: Endocr J. Peter SA. American Society of Health-System Pharmacists, Inc. Disclaimer, U.S. Department of Health and Human Services. A 15-year-old girl had a history of diffuse goiter and received methimazole treatment 2 months before admission to the hospital. Hung YT, Yu WK, Chow E. Delayed cholestatic hepatitis due to methimazole. Shipp JC. Withdrawal symptoms vary from person to person, and they can change quickly. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. Adults. A single copy of these materials may be reprinted for noncommercial personal use only. National Institute of Diabetes and Digestive and Kidney Diseases. Methimazole. Methods Thirty-eight patients with Graves' hyperthyroidism (M15/F23. Drug-induced acute liver failure: results of a U.S. multicenter, prospective study. Gallelli L, Staltari O, Palleria C, De Sarro G, Ferraro M. Hepatotoxicity induced by methimazole in a previously healthy patient. Coughing up blood. Ranging from mild to moderate to severe, you may experience any or all the following: 4 Urges and cravings that vary in intensity Sleep disturbances such as insomnia and nightmares Heart rate and blood pressure increases 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. Most notably, pregnant women. Deidiker R, deMello DE. With medical big data and AI algorithms, eHealthMe is running millions of phase IV trials and makes the results available to the public. Chalana H, Kundal T, Gupta V, Malhari AS. Could the anxiety be stemming from you actually still needing the methimazole? Careers. Toxic hepatitis during treatment with methimazole (Tapazole). This means that even if you relapse and use an opioid, you wont get high (but you can overdose). Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Other side effects not listed may also occur in some patients. Common side effects of Tapazole include rash, itching, hives, abnormal hair loss, skin pigmentation, swelling, nausea, vomiting, heartburn, loss of taste, joint or muscle aches, numbness, and headache. You are right that beta blocker heart and blood pressure medications such as atenolol, carvedilol, metoprolol and propranolol should never be stopped suddenly. MMI treatment induces evident changes in thyroid hypoechogenicity, mainly in patients who subsequently go into remission. Methadone isproven safe and effective for use during pregnancy. abnormal sensations (tingling, prickling, burning, tightness, and pulling), right-sided abdominal pain with decreased appetite. A case of methimazole-induced acute hepatic failure in a patient with chronic hepatitis B carrier. Maci-Bobes C, Ronzn-Fernndez A, Macas-Robles MD, Fau-Cubero C. Regelmann MO, Miloh T, Arnon R, Morotti R, Kerkar N, Rapaport R. Graves disease presenting with severe cholestasis. symptoms related to substance abuse may be felt for weeks, months, and sometimes years. Check with your medical doctor before having any dental work done. Antithyroid drugs. Cooper DS, Rivkees SA. Neither thyroid hypoechogenicity score nor TRAb values evaluated in basal conditions, showed significant differences between patients remaining euthyroid and those who became again hyperthyroid. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Thyroid vascularization is an important ultrasonographic parameter in untreated Graves' disease patients. Andersen SL, Olsen J, Wu CS, Laurberg P. Birth defects after early pregnancy use of antithyroid drugs: a Danish nationwide study. It is not unusual for people with opioid use disorders to go on and off methadone over the course of several months or years. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. If your dose is different, do not change it unless your doctor tells you to do so. Bone or joint pain. The study uses data from the FDA. Store it at room temperature and away from excess heat and moisture (not in the bathroom). These symptoms might include sweating, yawning, runny nose, restlessness, and insomnia. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Epub 2007 Aug 3. In Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Methadone withdrawal can resemble the symptoms of withdrawal from other opioids. Check with your doctor immediately if any of the following side effects occur: Some side effects may occur that usually do not need medical attention. Symptoms occurring after RAI therapy were evaluated by a questionnaire administrated to each patient 1 month after radioiodine therapy. It is a synthetic opioid that works like other common opioids, which means that it is addictive. Took methimazole for 5 yrs, dropping it once after to to see on doc's orders. Knowing the odds will help you understand the value of ongoing treatment. Opioids affect the way your brain works, flooding your brain with euphoria-inducing neurotransmitters every time you get high. Indeed, more than half of patients with untreated hyperthyroidism have serum enzyme abnormalities (usually less than 5 times the upper limit of the normal range) and a small proportion are jaundiced and present with cholestatic hepatitis. Methimazole Recruiting Phase 4 Trials for Drug Withdrawal Symptoms / Graves' Disease / Drug Relapse / Treatments Treatment. Tapering methadone means gradually taking smaller doses over the course of several weeks or months. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. A study of four cases. With a short-acting opioid, these withdrawal symptoms can be intense, but they typically peak within a couple of days and then begin to resolve. It works by making it harder for the body to make thyroid hormone. Although the laws about opioid abuse during pregnancy do differ among the states, methadone is safe and legalyou should not run into any problems when you seek treatment. Both meds you're on take a little getting used to. Some reports may have incomplete information. Portions of this document last updated: Feb. 01, 2023, Original article: https://www.mayoclinic.org/drugs-supplements/methimazole-oral-route/side-effects/drg-20073004. Thank you, {{form.email}}, for signing up. Breastfeeding is generally considered safe during methadone treatment. Ji H, Yue F, Song J, Zhou X. The .gov means its official. These symptoms are most common in long-term opioid abusers. 614-5. Likelihood score: A (well known but rare cause of clinically apparent liver injury). Bjrnsson ES, Bergmann OM, Bjrnsson HK, Kvaran RB, Olafsson S. Incidence, presentation and outcomes in patients with drug-induced liver injury in the general population of Iceland. Methimazole may cause an upset stomach. Actual Study Start Date : December 23, 2017. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Other side effects not listed may also occur in some patients. Oral: Initial: 15 to 60 mg/day depending on severity of disease; usual maintenance dose: 5 to 15 mg/day. Remember that it is not uncommon for people to overdose and die during a relapse. When using methadone, you may experience . If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding: Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. Methimazole is an antithyroid medicine. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. https://www.mayoclinic.org/drugs-supplements/methimazole-oral-route/side-effects/drg-20073004, Advertising and sponsorship opportunities, Agranulocytosis (very low white blood cells) or, Aplastic anemia (very low red blood cells) or. Benzodiazepinesto treat short-term anxiety. Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters. J Clin Endocrinol Metab. Greenberger NJ, Milligan FD, DeGroot LJ, Isselbacher KJ. Nope, few short weeks and old tremors, anxiety, depression and "why can't I rip your head off?" returned. Thyroid hypoechogenic pattern at ultrasonography as a tool for predicting recurrence of hyperthyroidism after medical treatment in patients with Graves' disease. Lying or other unusual negative behavior such as sudden hostility or aggression. DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. Laboratory testing showed elevations in serum direct and total bilirubin and a cholestatic pattern of enzyme elevations. Low thyroid levels (hypothyroidism)unusual weakness or fatigue, increased sensitivity to cold, constipation, hair loss, dry skin, weight gain, feelings of depression. If you drink alcohol while taking a beta-blocker and your blood pressure drops too much, you may experience the following symptoms: dizziness lightheadedness fainting, especially if you get up. Keep all appointments with your doctor and the laboratory. Posology. Many people find support at local 12-step meetings, such as Narcotics Anonymous. They do better controlling their thyroid hormones using Regular L-Carnitine. Association between genetic polymorphisms of SLCO1B1 and susceptibility to methimazole-induced liver injury. tell your doctor and pharmacist if you are allergic to methimazol, lactose, or any other drugs. 13th ed. Hepatitis from methimazole during adrenal steroid therapy for malignant exophthalmos. Twelve and 24 months after withdrawal, there were 10 (25.6%) and 17 (44.7%) relapses, respectively. In the whole group, the thyroid hypoechogenicity score was significantly lower at the withdrawal than in basal conditions (1.1 +/- 1.1 vs 2 +/- 0.8; P < 0.0001); it was significantly lower in patients in remission (P < 0.001), but not in those who relapsed. For over 20 years Dr. Umhau was a senior clinical investigator at theNational Institute on Alcohol Abuse and Alcoholismof the National Institutes of Health (NIH). 9 These symptoms can last a few weeks. These side effects may go away during treatment as your body adjusts to the medicine. A characteristic thyroid ultrasonographic picture with diffuse or scattered low echogenicity has been described in Graves' disease (GD). Check with your doctor right away if you have constipation, a depressed mood, dry skin and hair, feeling cold, hair loss hoarseness or husky voice, muscle cramps and stiffness, slowed heartbeat, weight gain, or unusual tiredness or weakness. burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings chest pain chills cough dark urine difficulty in breathing dizziness or lightheadedness drowsiness feeling of constant movement of self or surroundings fever general feeling of discomfort, illness, or weakness headache hoarseness itching, skin rash It is also important information to carry with you in case of emergencies. 2019 Jan 19;15:65-69. doi: 10.1016/j.jcte.2019.01.001. Unable to load your collection due to an error, Unable to load your delegates due to an error. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. Thyroid hypoechogenicity in GD at onset has been considered a prognostic index of relapse after medical treatment; moreover, thyroid hypoechogenicity is regularly observed in GD at the onset, but not in patients with 'burned-out' disease. Typical cholestatic hepatitis arising one month after starting therapy with methimazole. Different individuals may respond to medication in different ways. Insomnia or inability to sleep. Successful treatment with carbimazole of a hyperthyroid pregnancy with hepatic impairment after propylthiouracil administration: a case report. It is the most common cause of hyperthyroidism (overactive thyroid gland). eHealthMe is studying from 6,259 Methimazole users for its effectiveness, alternative drugs and more. If you notice any other effects, check with your healthcare professional. You can find a meeting near you with theirsearchable directory. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Unauthorized use of these marks is strictly prohibited. Clients may be affected by less intense versions of the acute signs and symptoms of withdrawal as well as by other conditions such as impaired ability to check impulses, negative emotional states, sleep disturbances, and cravings. The most common signs you should watch for include: Vomiting or regurgitating undigested food No appetite (refusing to eat) Rash Swelling of the face Take methimazole with food or milk. FDA approves the first non-opioid treatment for management of opioid withdrawal symptoms in adults. These could be symptoms of a serious liver problem. Report of a case with apparent recovery. Call your doctor for medical advice about side effects. Methadone maintenance treatment. eCollection 2021. Drug information provided by: IBM Micromedex. Methimazole is also capable of causing clinically apparent, idiosyncratic liver injury. Common side effects of methimazole may include: nausea, vomiting, upset stomach; headache, dizziness, drowsiness; numbness or tingly feeling; rash, itching, skin discoloration; muscle or joint pain; hair loss; or decreased sense of taste. For this medicine, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. The dose of this medicine will be different for different patients. Because naltrexone can bring on instantaneous withdrawal, you shouldnt start using it until all the methadone is out of your system. Other drugs that have the same active ingredients (e.g. It is important to drink enough water to allow the body to heal properly. Duplication for commercial use must be authorized by ASHP. Relapse is a part of the recovery process. These meds don't work instantaneously, like antibiotics, etc. Schwab GP, Wetscher GJ, Vogl W, Redmond E. Methimazole-induced cholestatic liver injury, mimicking sclerosing cholangitis. Shortness of breath. Stay hydrated. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Proper addiction treatment takes a multifaceted approach that combines medication management with psychotherapy and social support. Propylthiouracil-associated hepatitis. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. Reuben A, Koch DG, Lee WM., Acute Liver Failure Study Group. The National Institute and the American Substance Abuse Centers recommend that detoxification and subsequent addiction treatment for dual diagnosis of cocaine and methimazole be supervised by a physician in a professional facility to help manage withdrawal symptoms and prevent relapse. But sometimes, it doesn't work well enough and RIT is suggested. 2023 eHealthMe.com. Disclaimer. Fatal cases are rare. The presence of hyperthyroidism may play a role in worsening liver function, and temporary management with beta-blockers or other approaches may be necessary even during the course of the acute liver injury. PMC Our analysis results are available to researchers, health care professionals, patients (testimonials), and software developers (open API). Withdrawal symptoms such as tremors, anxiety, sweating, insomnia, pain, or hallucinations when you are unable to take the next dose of methaqualone. Huang MJ, Li KL, Wei JS, Wu SS, Fan KD, Liaw YF. Post-acute withdrawal, which is also known as protracted withdrawal, begins in the weeks following your detox. Rosenbaum H, Reveno WS. Features and outcomes of 899 patients with drug-induced liver injury: The DILIN Prospective Study. Agranulocytosis and toxic hepatitis from methimazole. What special dietary instructions should I follow? If you relapse with heroin or prescription painkillers, you will be at risk of a life-threatening overdose. However, you should not flush this medication down the toilet. Waseem M, Seshadri KG, Kabadi UM. Copyright 2023 IBM Watson Health. 3rd ed. A burning, numbness, or tingling feeling that is not normal. Tests for hepatitis A, B and C and autoantibodies were negative. Working closely with a doctor, you can extend your taper timeline and reduce your dose by smaller increments if necessary. Feeling like you have a bad flu, vomiting, diarrhea, sweating, and insomnia are all common. Relapse rates among people with opioid use disorders are very high. Tennenbaum JI, Dreskin OH. Thirty-nine consecutive patients aged 10-72 years were treated with methimazole (MMI) for 12-24 months on a titration regimen. Lucemyra works by reducing the release of norepinephrine, a neurotransmitter that researchers believe plays a role in the symptoms of opioid withdrawal. Vomiting and diarrhea. These numbers arent pretty, but dont let them scare or discourage you. 3. 432 Objectives To evaluate whether 3-day withdrawal of methimazole (MMI) prior to radioactive iodine therapy (RAI) is adequate in Graves' disease with adjunctive MMI treatment. Newsletters Subscribe Press NAVC Brands Menu Articles Back Topics Back Anesthesiology Behavior Cardiology Clinical Pathology Cytology Dentistry Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Generally, the longer you use it the better your chances of recovery, but because its an opioid, stopping methadone causes opioid withdrawal. Fear . They can be extremely frustrating for both people in recovery and their loved ones. Because of the hepatotoxicity of propylthiouracil which can be fatal, methimazole is now considered the first line treatment for hyperthyroidism when there is a need to avoid surgery or radioiodine therapy. Babini G, Gurioli L, Rizzi R, Bertello P. Appearance of severe jaundice after radiometabolical treatment of thyrotoxicosis. The only time I actually went off of Methimazole was when I was pregnant (I had reached euthyroid a couple months before) and I think I experienced similar symptoms of anxiety and headaches for a couple weeks. Other people think its worse than withdrawing from a short-acting opioid like heroin. Official Title: The Effect of Intestinal Microbiota on Treatment Sensitivity and Prognosis of Methimazole for GD. bloody or cloudy urine burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings chest pain chills cough dark urine difficulty in breathing dizziness or lightheadedness drowsiness feeling of constant movement of self or surroundings fever general feeling of discomfort, illness, or weakness headache hoarseness The https:// ensures that you are connecting to the Certain symptoms may peak after about three days.. Hyperthyroidism due to Graves' disease is treatable with medicine. Option #3: Low dose naltrexone (LDN). Although not all of these side effects may occur, if they do occur they may need medical attention. Some people may also be allergic to the herb. * Approximation only. After 48 months of methimazole withdrawal, the primary outcome, which was a relapse of hyperthyroidism, was detected in 16 patients (67%) in the ST group and in 3 patients (12.5%) in the LT group ( P < .001). To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location one that is up and away and out of their sight and reach. Muscle weakness and cramps Joint pain Low blood sugar levels Excessive sweating Confusion Memory loss Mood changes Psychosis or hallucinations (disturbances of the mind) Changes in sex drive or sexual performance (such as erectile dysfunction) Skin rashes or exacerbation of exciting skin conditions like psoriasis Chalasani N, Bonkovsky HL, Fontana R, Lee W, Stolz A, Talwalkar J, Reddy KR, et al. They may advise waiting until your body feels back to normal. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. Yang J, Zhong J, Zhou LZ, Hong T, Xiao XH, Wen GB. Methimazole is an antithyroid medication which is now considered the first line agent for medical therapy of hyperthyroidism and Graves disease. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. Yang J, Li LF, Xu Q, Zhang J, Weng WW, Zhu YJ, Dong MJ. Sometimes one dose reduction is harder than the others and uncomfortable withdrawal symptoms occur. Cross-Sectional. Portions of this document last updated: Feb. 01, 2023. government site. Dose reductions can occur once a week, once every two weeks, or less often. Methimazole (oral and transdermal) is a safe and effective medication for the treatment of feline hyperthyroidism. Advertising revenue supports our not-for-profit mission. joint pain or swelling. Thyroid and anti-thyroid drugs. The presence of other medical problems may affect the use of this medicine. Accessibility Martinez-Lopez JI, Greenberg SE, Kling RR. She did not have abdominal pain, nausea, fever or rash. Steroid nasal sprays do not usually cause any significant side effects if used correctly and at normal doses. 2016;2016:1-7. doi:10.1155/2016/7620860, Amato L, Minozzi S, Davoli M, Vecchi S. Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification.Cochrane Database of Systematic Reviews. Spontaneously reported hepatic adverse drug events in Korea: multicenter study. Talk to your veterinarian about any side effect that seems unusual or bothersome to the animal. Unusual complications of antithyroid drug therapy: four case reports and review of literature. Information is also available online at https://www.poisonhelp.org/help. CARDIOVASCULAR PROBLEMS Stopping thyroid medication suddenly increases the risk of elevated cholesterol, fluctuating blood pressure, and heart disease. Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Liaw YF, Huang MJ, Fan KD, Li KL, Wu SS, Chen TJ. Results: Twelve and 24 months after withdrawal, there were 10 (25.6%) and 17 (44.7%) relapses, respectively . Swelling. Jaundice and thyrotoxicosis in the absence of congestive heart failure. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. How Long Does Withdrawal From Antidepressants Last? OTC pain relievers, like Tylenol or Advil, to treat aches and pains. This can help avoid unpleasant side effects (withdrawal symptoms), such as severe tiredness, joint pain, being sick and dizziness. This is not a complete list of side effects and others may occur. decreased blood platelets. Basal thyroid hypoechogenicity cannot be used as an index of relapse of GD. Predictors of relapse after inpatient opioid detoxification during 1-year follow-up. Hormonal derivatives and related drugs. Once they reach peak severity, your symptoms will begin to resolve. Some people go into it thinking its going to be a nightmare, but it turns out to be milder than they anticipated. 2007 Dec;54(5):713-20. doi: 10.1507/endocrj.k06-069. CT imaging of the abdomen showed no evidence of biliary obstruction. Analysis of antithyroid drug-induced severe liver injury in 18,558 newly diagnosed patients with Graves' disease in Japan. Abrupt discontinuation has led to chest pain, irregular heart rhythms or even heart attacks. Feeling jumpy and restless. Methimazole has active ingredients of methimazole. Analysis of 90 cases of antithyroid drug-induced severe hepatotoxicity over 13 years in China. Arab DM, Malatjalian DA, Rittmaster RS. The use of the eHealthMe site and its content is at your own risk. HHS Vulnerability Disclosure, Help Clipboard, Search History, and several other advanced features are temporarily unavailable. Stage 2 (24-72 hours after the last drink): The common symptoms during this stage are high blood pressure .