Liver cirrhosis is severe scarring that involves permanent damage to the liver. No medications can specifically treat liver disease, but acetaminophen (Tylenol) and other options can help relieve pain.
The liver is responsible for breaking down substances a person consumes, so someone with liver damage needs to be careful when taking medications and supplements.
Most medications are safe for people with mild liver disease. However, it is important for people with liver conditions to talk with a doctor before taking any new medications.
Someone with cirrhosis, a severe form of liver damage, must be very careful when taking prescription or over-the-counter (OTC) medications.
This article looks at the various medications for liver cirrhosis, including first-line treatments, drugs to improve liver function, and medications for pain management.
The treatment protocol for liver cirrhosis typically involves:
- treating the underlying cause of the disease
- preventing complications
- treating symptoms
While treatment cannot reverse the liver damage, it can stop the condition from getting worse and prevent liver failure. At present, there is no cure for cirrhosis.
People should also avoid consuming alcohol regardless of the cause of their liver damage. Doctors may prescribe various medications or therapies to treat the following symptoms of liver cirrhosis:
- ascites (abdominal swelling)
- hepatic encephalopathy, when ammonia builds up and affects the brain
- hepatorenal syndrome, when the kidneys can no longer eliminate waste and begin to fail
- jaundice (yellowing of the skin)
- varices (enlarged veins)
There are various underlying causes of cirrhosis, and healthcare professionals usually recommend managing cirrhosis by treating its underlying cause. Treatments for some of these conditions are
- Alcoholic liver disease: quitting alcohol, alcohol treatment
- Autoimmune hepatitis: immunosuppressants
- Chronic hepatitis B: antiviral medications
- Chronic hepatitis C: antiviral medications
- Nonalcoholic fatty liver disease: nutritious diet, exercise
- Medication-induced liver disease: cessation of medication
If a person has severe cirrhosis, a doctor may recommend a liver transplant.
There is currently no approved drug for the treatment of cirrhosis. However, researchers are actively looking into options to treat the condition, including synthetic drugs.
While liver cirrhosis is often painful, it can be difficult to treat because liver disease can increase the risk of drug reactions. Some doctors may be reluctant to prescribe pain relief drugs because of the potential side effects.
According to one 2020 review, acetaminophen (Tylenol) is the first-line treatment for pain in people with chronic liver disease.
While large amounts of acetaminophen can be harmful to people with liver disease, smaller doses are generally safe. A
However, it is important that people follow dosing instructions from a doctor because of the risk of liver toxicity.
People with liver cirrhosis should avoid nonsteroidal anti-inflammatories (NSAIDs) because they can increase a person’s risk of gastrointestinal bleeding, kidney failure, and other complications. Serotonin-norepinephrine reuptake inhibitors (SNRIs) may also pose a risk to people with cirrhosis.
The same 2018 review also makes the following recommendations for treating pain in people with cirrhosis:
- gabapentin for neuropathic pain, starting at 300 milligrams (mg) daily
- topical lidocaine, up to three patches at once
- nortriptyline, 10 mg per night
Doctors may also prescribe certain opioids to treat severe pain in people with cirrhosis, such as:
Managing pain in people with cirrhosis is challenging, and there is no one-size-fits-all approach. People should work with a doctor to find the approach that works best for them.
A person with known cirrhosis should consider contacting a doctor before taking any medication or supplement. Even OTC medications may carry some risk.
If they notice their symptoms worsening, they should seek medical attention.
Liver cirrhosis is severe liver scarring. There is no cure for the condition, and treatment typically involves treating the underlying cause.
People with severe liver disease should be careful when taking medications and supplements because liver damage affects metabolism and may increase the risk of adverse effects. A doctor can recommend safe options and dosages.