To the Editor: The duty to relieve symptoms, safely, is a preeminent one of health care professionals. We appreciate the concerns of Chandok and Watt about the need for cautious use of opioids, particularly in patients with advanced liver disease. Indeed, we concur that caution should be exercised by all health care experts.
Furthermore, claims of “any sign of necessitates immediate discontinuation of the opiate” are misleading. Indeed, in a reference cited by Chandok and Watt, those authors 8 note that “were alternative analgesia not available, should be prescribed lower doses of opioids, with extended dosing intervals.” Clinical context is required in all these settings, and we concur that it is likely that clinical prudence may suggest titrating opioid doses downward, increasing dosing interval, or rotating to an alternative agent as appropriate options, rather than abruptly discontinuing opioid therapy.
Your liver sees medications as toxins. When your liver is compromised, medications that are normally considered “safe” may no longer be safe for you. The safest pain medicine for someone with cirrhosis is acetaminophen (Tylenol). However, even this is more risky in people with cirrhosis. That's because.
Dr. Anthony Komaroff, Harvard Medical School| In Association with Harvard Health Publications.
Cirrhosis, a liver disease, interferes with the liver’s ability to detoxify substances in the blood. One of the liver’s many jobs is detoxification — ridding the blood of toxins.
That’s the equivalent of two regular-strength acetaminophen tablets. Take acetaminophen for the shortest time as possible. I advise patients with cirrhosis not to take more than 2,000 milligrams (mg) in one day, or more than 650 mg per dose.
Acetaminophen is particularly troublesome in this regard, as it is available over the counter and it has been widely marketed as safe, which leads many people to believe it is safe at any dose. Furthermore, acetaminophen is frequently combined with narcotics in prescription pain medications; liver damage.
Acetaminophen, also known as Tylenol, is an “intrinsic” liver toxin, meaning it stresses your liver’s metabolic capacity at nearly any dose. Alcohol and aspirin are also intrinsic liver toxins. Your liver is usually capable of handling such substances when they are taken in smaller amounts, but moderay high doses over long periods of time can cause chronic liver enzyme elevation, and massive doses can cause acute liver failure. Acetaminophen is particularly troublesome in this regard, as it is available over the counter and it has been widely marketed as safe, which leads many people to believe it is safe at any dose.
I was diagnosed with cirhosis of the liver, alchohol related, about 18 years ago and was told that i would probably need a transplant within 5 years to survive. so far, so good. i'm just wanting to know if there are any pain relievers out there that are safe for me to take. Answer this Question · Report Favorite.
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provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. To view content sources and attributions, please refer to our editorial policy. Data sources include Micromedex (updated Dec 4th, 2017), Cerner Multum (updated Dec 5th, 2017), Wolters Kluwer (updated Dec 1st, 2017) and others.
Basically, try 2 stay away from anything w/ acetomenephen (Tylenol) so drugs like Percocet, the Hydrocodones.
If you have liver disease you should not drink alcohol (less is better, none is the best). Pain relievers such as Tylenol (acetaminophen) is safe if you take less than six 325 mg tablets each day (2 gms). Ibuprofen is safe if you have no ulcers, cirrhosis and normal kidneys. Do not use nasal decongestants/antihistamines such.
Sutter Health is a registered trademark of Sutter Health, Reg. Levin, MD Department of Transplant. Other important functions of the liver include: Clearing the body of toxins and drugs Making proteins, including albumin; some of which help your blood to clot Making hormones involved in the regulation of growth, blood pressure and iron levels Storing energy as a special form of sugar (glycogen) that can be used by the rest of the body Storing certain vitamins, such as vitamins B12, A, D and K As the liver fails, its functions become less efficient.