The recurrence of liver injury after re-administration (often inadvertent) of a suspected drug is the most definitive evidence for drug-induced liver disease and may outweigh other considerations in causality assessment. The biochemical criteria for a positive rechallenge have been outlined by the consensus group (Benichou, 1990). But, rechallenge of an incriminated drug can be dangerous and may even be fatal (Ransohoff and Jacobs, 1981; Lo et al., 1998). Deliberate rechallenge may only be justified when continued treatment with the implicated agent is highly desirable.

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