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Drug Info

Medication for fatty liver: Rezdiffra and other options

Commonly prescribed medications for managing fatty liver disease
Gerardo Sison medical writer headshot
By | Jul. 2, 2025
A pill bottle with various colored pills falling out of it:

Key takeaways

  • Rezdiffra is the first FDA-approved treatment for fatty liver disease with scarring that can help reduce fat, inflammation, and fibrosis.

  • GLP-1 receptor agonists like Ozempic and Mounjaro support liver health by lowering liver fat, improving blood sugar, and supporting weight loss.

  • Other options, such as thiazolidinediones, SGLT2 inhibitors, and statins, may help manage fatty liver disease by managing related metabolic problems.

In this article:

Fatty liver disease can occur when extra fat builds up in the liver. There are two main types: alcoholic fatty liver disease, which is from drinking too much alcohol, and nonalcoholic fatty liver disease (NAFLD), which is linked to problems like obesity and diabetes. However, the term metabolic dysfunction-associated steatotic liver disease (MASLD) has replaced NAFLD to better describe this group of liver problems. 

Without the right treatment, fatty liver disease can worsen, leading to liver scarring called fibrosis and even progressing to cirrhosis, liver failure, jaundice, and liver cancer. Although lifestyle changes, such as eating a balanced diet and getting more exercise, are key, these changes aren’t always enough. Healthcare providers may recommend medication to help lower liver fat, control sugar and cholesterol levels, and support overall liver health.

Read on to learn more about medications for fatty liver disease. 

Can medication cure fatty liver disease?

There is no one medication that can cure fatty liver disease. Instead, medications can manage symptoms and lower the risk of liver scarring or fibrosis. The main treatment goals are reducing liver fat, reducing inflammation, and preventing ongoing liver damage. Healthcare providers typically check liver health with blood tests, imaging like elastography, and sometimes a liver biopsy.

Some medications target inflammation and liver function, especially in people with more advanced liver scarring. Other medicines might help improve insulin resistance and support liver health in people with risk factors like obesity or metabolic syndrome.

Still, dietary changes and increased exercise are typically recommended first. Weight loss and reducing alcohol use can lower the chance of further liver damage and decrease the risk of cardiovascular problems like heart disease. For most people, medication works best when combined with healthy lifestyle changes.

Current medications used for fatty liver

The first and only drug approved by the Food and Drug Administration (FDA) for liver scarring from fatty liver disease is Rezdiffra (resmetirom). This medicine, approved in 2024, targets a thyroid receptor in the liver, reducing fat, inflammation, and scarring. It is often used for adults with nonalcoholic steatohepatitis (NASH) who do not yet have cirrhosis.

Other medications may be used off-label to manage fatty liver disease or treat other conditions associated with the disease, such as diabetes and obesity. 

GLP-1 receptor agonists

Glucagon-like peptide-1 (GLP-1) receptor agonists are a type of medicine used to help with fatty liver disease and related conditions. These drugs mimic the actions of a natural hormone in the gut called GLP-1. They help control blood sugar, decrease appetite, and promote weight loss, all of which may help reduce fat in the liver.

Some GLP-1 receptor agonists used for fatty liver might include:

  • Victoza (liraglutide)
  • Ozempic (semaglutide)
  • Trulicity (dulaglutide)
  • Mounjaro (tirzepatide)

One meta-analysis showed that GLP-1 agonists helped lower liver enzymes, liver fat, blood sugar, and body weight more than regular treatment or a placebo. People taking these medications were also about six times more likely to see improvement in their liver condition compared to those who didn’t take them. 

For some people, results may not last if they stop taking the medicine or don’t maintain healthy habits. Possible side effects include nausea, vomiting, diarrhea, and sometimes constipation. Most side effects are mild and go away over time, but some people may feel uncomfortable when starting treatment.

Thiazolidinediones

Thiazolidinediones, called TZDs for short, are a group of medicines that help the body use insulin better. Healthcare providers usually prescribe these drugs for Type 2 diabetes, but some also prescribe them to treat liver problems linked to fat buildup in the liver.

These drugs work by activating a protein called PPAR gamma, which helps control how the body handles fat, sugar, and inflammation. When PPAR gamma gets activated, it can help lower liver fat and improve how the liver works.

Common TZDs used for fatty liver disease include:

  • Actos (pioglitazone)
  • Avandia (rosiglitazone)

Among these, pioglitazone is often the preferred choice for patients with fatty liver diseases, as clinical trials have shown it helps resolve NASH and improve liver histology. For example, in one study, 51% of patients treated with pioglitazone no longer had NASH compared to 19% on placebo. However, TZDs are not perfect. Side effects may include weight gain, swelling in the legs, and sometimes a higher risk of bone fractures.

SGLT2 inhibitors

SGLT2 inhibitors are a class of drugs used to help control blood sugar in people with Type 2 diabetes. They work by helping the kidneys remove extra sugar through urine. They can also help with weight loss and lower the risks of heart and kidney problems.

Researchers have found that SGLT2 inhibitors may improve liver health in people with fatty liver disease. They can lower the amount of fat in the liver, reduce liver enzyme levels, and improve scarring. Using SGLT2 inhibitors can lead to lower insulin levels, which may help the liver burn more fat instead of storing it.

Some SGLT2 inhibitors used for fatty liver disease may include:

Common side effects people may notice are frequent urination, urinary tract infections, or yeast infections. There is also a risk of dehydration, which may cause increased thirst, dizziness, or low blood pressure, especially when standing up quickly.

Vitamin E

Vitamin E is an antioxidant that helps protect liver cells from damage by blocking harmful molecules called free radicals. Several studies show that vitamin E can lower oxidative stress and improve markers of liver injury in people with fatty liver disease, even if they don’t have concurrent diabetes. However, vitamin E doesn’t seem to reverse scarring (fibrosis) in the liver.

Combining pioglitazone with vitamin E has been shown to have a greater positive effect on reducing hepatic inflammation than vitamin E alone. This combination can help reduce liver inflammation and cell swelling but still does not fix liver fibrosis. While vitamin E may help some fatty liver symptoms, it is not a cure and may not work the same way for everyone.

Statins

Statins are medicines used mostly to lower cholesterol but may help improve liver function and overall liver health. People with fatty liver disease might also have health conditions like high cholesterol, diabetes, or heart problems. Statins can help manage these conditions at the same time.

Some studies suggest statins might even help slow down liver damage for certain people. One study found that people with MASLD who took statins had a lower risk of serious liver problems, such as liver cancer or liver failure, than those who did not take statins. For example, only 1.6% of statin users had major liver events compared to 2% of non-users over about 10 years.

Common statins include:

Most people can take statins safely. But like all medicines, statins may sometimes cause side effects. The most common side effects of statins are muscle aches, mild stomach upset, or, rarely, changes in liver test results. Regular checkups can help spot any problems early.

The future of medications for fatty liver 

Researchers are working on many different types of drugs for fatty liver disease. Some new treatments target specific processes in the liver. For example, certain drugs called FXR agonists can help control fat and inflammation in the liver. These medicines offer benefits, but side effects such as itching and fatigue can make them difficult for some people to tolerate.

Other medications in clinical trials have been studied for how they affect fat and sugar metabolism. One prospective drug called retatrutide targets three different hormone receptors to regulate blood sugar and lower body weight, which may help support liver health. In one study, people with fatty liver disease who took the drug once a week for 24 weeks saw significantly reduced fat in their liver. Depending on the dose, liver fat dropped by 43% to 82%, while those who got a placebo had no change.

Drugs that work on FGF19 and FGF21, proteins that have effects on metabolism, also show promise. In short-term studies, these medicines helped decrease liver fat and inflammation in some patients. Newer treatments, like PPAR agonists and ACC inhibitors, could change how the liver makes and uses fat, which may help slow down or stop liver damage.

Bottom line

Healthcare providers may use medication to help with fatty liver, but most of the time, lifestyle changes come first. Common treatment options include weight loss through being more active and making more balanced food choices. If these steps are not enough, a healthcare provider may prescribe medication to manage liver inflammation or other health problems. 

FDA-approved Rezdiffra and drugs like GLP-1 agonists, TZDs, and SGLT2 inhibitors may help reduce liver fat, control blood sugar, and lower inflammation. Supplements like vitamin E and common cholesterol drugs such as statins may also support liver health. Ongoing research may lead to more effective treatments in the future.