Alverine dtrate is a commonly used smooth muscle relaxantagent.A MEDLINE search on January 2004 revealed only 1report implicating the hepatotoxicity of this agent.A 34-year-old woman was investigated because of the finding ofelevated liver function tests on biochemical screening.Otheretiologies of hepatitis were appropriately ruled out andelevated enzymes were ascribed to alverine citrate treatment.Although alverine citrate hepatotoxicity was related to animmune mechanism in the first case,several features suchas absence of predictable dose-dependent toxicity of alverinecitrate in a previous study and absence of hypersensitivitymanifestations in our patient are suggestive of a metabolictype of idiosyncratic toxicity. Alverine dtrate is a commonly used smooth muscle relaxantage. A MEDLINE search on January 2004 revealed only 1report implicating the hepatotoxicity of this agent. A 34-year-old woman was investigated because of the finding ofevated liver function tests on biochemical screening. Ottotiologies of hepatitis were appropriately ruled out andelevated enzymes were ascribed to alverine citrate treatment were also related to animmune mechanism in the first case, several features suchas absence of predictable dose-dependent toxicity of alverine citrate in a previous study and absence of hypersensitivity in menifestations in our patient are suggestive of a metabolictype of idiosyncratic toxicity.