Flutamide is the active substance of the drug and belongs to the group of drugs that have antiandrogenic effect. Flutamide prevents the action of male sex hormones, i.e. suppresses the action of testosterone and dihydrotestosterone. Primarily, the indications for the use of flutamide refer to males and the treatment of advanced prostate cancer. It is also used in the treatment of patients with testicles surgically removed, and in patients who have not responded to another type of therapy or do not tolerate other types of treatment. The efficacy of flutamide has also been proven in the treatment of acne, hirsutism and alopecia in men and women with polycystic ovaries. It is important to emphasize that flutamide can cause severe side effects, above all liver damage, so it is not justified to use it in the treatment of conditions other than prostate cancer. Numerous data on hepatotoxicity (retrospective, prospective studies, case reports, surveillance study) were available in literature, which ranged from asymptomatic to acute, fulminant hepatitis that ended in transplantation, i.e. fatal outcome. In our paper, a review of the literature with case reports of notably hepatotoxicity is presented along with a case from our clinical practice.

This review article includes a review of the latest literature searched on PubMed in the field of hepatotoxicity caused by drugs that have a wide daily application. The concept of the review article consists of several parts dealing with the definition of drugs induced liver injury - DILI, diagnostic challenges related to it, and the clinical spectrum of liver disease, with an emphasis on the development of nonalcoholic fatty liver disease - NAFLD and review of drugs involved in formation of NAFLD.

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