ollowing elective percutaneous coronary intervention (PCI), a 56-year-old man received clopidogrel 75 mg OD along with his long-term medication (> five years treatment with aspirin 75 mg OD and simvastatin 40 mg OD). Pre-PCI, his liver biochemistry (LFT’s) was normal. Two months post PCI the patient complained of general malaise and was found to have deranged LFT’s - [Figure 1]. There was no history of alcohol abuse.Drug-induced liver disease was suspected and the patient was advised to discontinue clopidogrel. Serology for acute viral hepatitis, anti-mitochondrial antibody and anti-smooth muscle antibody all proved negative. Abdominal ultrasound revealed no abnormalities. At four weeks there was a marked improvement in his LFTs [Figure 1]. Clopidogrel was reintroduced but the patient again developed non specific symptoms and deranged LFTs [Figure 1]. Clopidogrel was discontinued indefinitely.Clopidogrel-induced hepatotoxicity is an extremely rare side-effect (six cases in the published literature) and has not been reported in healthy volunteers.