Acetaminophen

[lsarmi]

A friend told me Acetaminophen (Tylenol) is bad for the liver.  Is this true?  Are other pain killers/headache meds. also bad for the liver?

I suffer from migraines, so I take a lot of excedrin which has acetaminophen, and I've been diagnosed with fatty liver.  

Can you recommend an alternative?

Thanks,

[barryd]

i use ibuprofen/moltrin , been on tx for 7 weeks,this usually helps with the aches and pains when i get them

[Soleus]

I copied this from http://hepatitis-central.com/

Patients with chronic hepatitis C often take the over-the-counter non- steroidal drug Ibuprofen (otherwise known as Motrin or Advil) to combat the joint pain that often accompanies the disease. But even a low dose could lead to unsuspected liver damage. "Patients frequently suffer from joint pain. Often, even physicians will prescribe ibuprofen when they should prescribe Tylenol," explains Thomas Riley, III, M.D., assistant professor of medicine at Penn State’s College of Medicine. "The correct recommendation to help the patient is a low dose of Tylenol, about 2 grams per day. That means the patient can take one extra strength Tylenol -- 500 mg -- every six hours or take two every 12 hours." Riley and his colleagues describe three cases in an article, "Ibuprofen Induced Hepatoxicity in Those With Chronic Hepatitis C: A Case Series," in the September issue of the American Journal of Gastroenterology.. In each of these three cases, the patients have hepatitis C and took over- the-counter ibuprofen. After doing so they all had a flare-up of their hepatitis. "Many physicians don’t want to prescribe Tylenol because it has a reputation of causing liver damage. As long as it is prescribed in the low doses we have discussed it is definitely the best treatment," explains Riley, who is also the medical director for the liver transplant program at The Milton S. Hershey Medical Center of the Penn State Geisinger Health System. Riley also says that while patients with chronic hepatitis C usually have mild elevations in liver enzymes in their blood, after taking the over-the- counter Ibuprofen they experience a ten-fold rise in their enzymes, suggesting significant liver injury.

[newco]

My gastro doc just told me today that using tylenol at the prescribed dose on the bottle is ok, when used in excess and used with alcohol is when it can do damage to the liver.
Newco

[cuteus]

I have been taking ibuprofen for many years 10 at least, and all during tx, I have never had an abnormal liver function test.
I would take the study presented with a grain of salt, since we don't know the actual liver condition of those with the flare ups(whatever that one means). just like tylenol, the ibuprofen should be safe to take in moderation.  Tylenol is such an inefective analgesic for me, that it would be a risk not worth taking in my case. these studies have to be analyzed for relevance to our own cases, otherwise we add to the paranoia of tx.

[layla]

I took aspirin during tx with approval from my hepatologist. Tylenol or motrin did not work for me. I think it all really has much to do with how much you take. LL

[Lynne5477]

I took tylenol all thru 48 wks of tx and still take it when needed.  For my migraines, my dr prescribed Imitrex and that worked wonders for me.  One tablet and it knocked the migraine out within 1/2 to 1 hour.

You might want to talk to your dr about something for the migraines.  It sure did cut down on the number of tylenol I was taking.

Good luck to you.

[TatMan1966]

I have stage III cirhosis, have been treated with both interferon and ribaviron (2000), and pegulated interferon and ribaviron (2007) and I have cryoglobulinemia, a high rhuematoid factor/ sed rate, djd/ddd, fibromyalgia, vaculitis, edema, periportal and general hepatic necrosis as a result. Tylenol is pretty much okay as long as you dont drink a drop of alcohol. Ibuprophen, or any other anti-inflametory I simply would not take. Another issue docotrs never tell anyone about is enzymes. You cannot assume your liver is okay just because you have your ALT's and AST's in check. I have mine checked every couple months. I can feel horrible, and they will be way low, or feel somewhat better and they will be way high. You can have one glass of wine, take one tylenol and then have your liver function test and look like on deaths door. You can also do this, and take dandilion tea, some milk thistle and some other herbs and make your enzymes look like you are a 20 year old with no disease. You do not know the status of the liver either until you have a biopsy, either. If you are symptomatic, I  urge you to not wait like I did. I have had this disease for a long, long time and please question the  doctors regarding treatments such as interferon and the sucess. Ask them question about your genotype and how responsive the so called cure is. Truthfully, I doubt I needed to be on this drug, and both times it has shown a huge jump in my viral load after a decrease. Now, they have fudge the numbers so they can call it a cure. If your viral load is below a certain number, you are not considered chronic or acute, then you are supossedly cured.....but just wait 6 months when it comes back with a vengance. I am genotype 2b, the most resposive. Both time, I went insane from a reaction (only 2% have it, so dont worry people) the last time I hung myself on accident with an electrical cord around my neck- thats how suicidal I was. I am not this way in real life. Both times, I had almost no virus left and both times after 6 months my viral levels shot up higher...much much higher than prior to the treatments. Worse yet, my immunes system went to hell, and now I have MRSA and cant get rid of it. I regret doing the treatments, and was swimming and working out and felt great prior to them. Thjey ruined my life, and I truly believe that it was unessassary. I am not saying it is inappropriate for some people, because some really really are in bad shape, so make sure you get a biopsy and dont do what I did. If you feel okay and your biopsy is good, question wether or not you really do need this treatment. Question the erradication of the virus. Ask the doctors how many people have had the virus wiped out. Be careful about the side effects, because 2% can go insane....and you wont realize it. If you are, I garuntee you will try killing yourself or someone else. It has happened, people have died. I dont know if this is entirely accurate, but to break down some medications like tylenol, you might lack Cytochrome P-450 and it might not work. Remember that hep can mess with your digestive system in its entirety, so some drugs with some fillers might not work that well. Tylenol can mess with your tests, so dont take it, or alcohol before your blood tests, or take any herbal remedies. The above is only describing my experiences, and not really telling anyone what or what not to do. I feel it is important for people to hear this, and my intention was not to scare anyone from treatment, because it does help some, however, it can hurt people all the same, and like me, you may not ever recover. I worked and my life was happy. Now I am permenantly disabled. Be careful, please because these otc medications can have a profound effect on the numbers, but might not means there is "damage". Cory