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Hepatocellular: Hepatocellular hepatotoxicity generally manifests as malaise and right upper quadrant abdominal pain, associated with marked elevation in aminotransferase levels (alanine aminotransferase [ALT], aspartate aminotransferase [AST], or both), which may be followed by hyperbilirubinemia in severe cases. Drug-induced liver injury (DILI) and herbal-induced liver injury (HILI) are well-recognized and symptomatically can mimic both acute and chronic liver diseases. It is reported that there are over 1000 prescription medications and over 100,000 herbal and dietary supplements available in the United States [ 1 ]. Drug-induced liver injury (DILI) and herbal-induced liver injury (HILI) are well-recognized and symptomatically can mimic both acute and chronic liver diseases. It is reported that there are over 1000 prescription medications and over 100,000 herbal and dietary supplements available in the United States [ 1 ]. Globally, there are an estimated 937 million overweight adults; currently, the USA claims the largest population of overweight and obese individuals []. In 2008, the National Health and Nutrition Examination Survey (NHANES) estimated that 33. 8% of adults and 16. 9% of children and adolescents aged 2–19 were obese while 68. 0% of adults and 31. Clenbuterol, also known by the trade name Epiphen buterol, is a beta-2 agonist drug used in the treatment of breathing difficulties in horses and other animals. It is available as a tablet or liquid and is injected or orally administered. Clenbuterol acts on the smooth muscle of the airways to improve breathing. Clenbuterol is a long-acting beta2-adrenoceptor agonist used to treat asthma and illegally by body-builders because of its anabolic properties. Exposure to clenbuterol-containing heroin can cause nausea, chest pain, palpitation, shortness of breath, and tremor. Physical findings include tachycardia and hypotension
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