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  1. Avoid hemolysis and lipemic serum which will give a false result.
  2. Avoid drugs which will increase the total bilirubin level like:
    1. Anabolic steroids.
    2. Antibiotics.
    3. Antimalarial drugs.
    4. Chlorpropamide.
    5. Methotrexate.
    6. An antihypertensive drug like methyldopa.
    7. Oral contraceptives.
    8. Antituberculous drugs like rifampin.

Normal Values


  1. Bilirubin estimation is one of the liver function test.
  2. It is raised in the hepatic and post-hepatic type of jaundice.
  3. Clinically jaundice appears when the level of bilirubin is more than 2 mg/dl.
  4. Direct (or conjugated) bilirubin. The Direct bilirubin dissolves in water (water soluble) and is synthesized in the liver from indirect bilirubin.

                                                                                                                     Bilirubin metabolism

Raised level of direct bilirubin is seen in:

  1. Gallstones.
  2. Gallbladder tumors.
  3. Inflammatory scarring or obstruction of extrahepatic ducts.
  4. Extensive liver metastasis.
  5. Dubin-Johnson syndrome.
  6. Rotor syndrome.
  7. Drugs may cause cholestasis.

Please see more details on bilirubin Total

Possible References Used

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