LIVER-SAFE PAIN MEDICATION?

RECENTLY DIAGNOSED W/ HEP C AND WAITING (5 WKS) FOR SPECIALIST APPT.  HAVING CHRONIC ACHE AND SOME PAIN. HAVING THE ACHE/PAIN IN AREA ABOUT 1-2 INCHES BELOW WAISTLINE FROM RIGHT SIDE ACROSS TO THE LEFT SIDE OF AREA BELOW WAISTLINE (ALTHOUGH MOSTLY ON RIGHT SIDE).  PAIN IS NOT USUALLY BAD BUT CONSTANT.  CALLED THE SPECIALIST TO SEE WHAT I COULD TAKE AND WAS TOLD THAT SINCE HE HAS YET TO SEE ME AS A PT. HE CANNOT TREAT THE PAIN.  THEY RECCOMENDED TYLENOL "BUT NOT EVERY DAY".  I WILL CALL MY REGULAR M.D. BUT DON'T TRUST HIM TO ORDER THE BEST FOR MY LIVER.  I WOULD LIKE TO KNOW WHAT IS TYPICALLY USED FOR PEOPLE WITH LIVER/PAIN PROBLEMS BEFORE I CALL MY REGULAR DR.
THANKS!!!
VICKI

[Kalio1]

I take Vicoprophen, it is processed by the kidneys.
It works very well and doesn't get me all dinged out or fuzzy headed but works well on the pain. At first one pharmacy I went to had to get some as they mostly give out Vicodin not Vicoprophen, but after the initial glitch it's been fine.

One common use is dentists give it out frequently for tooth pain.

Try not to worry too much, all the waiting on appts drives you bonkers. Maybe once you control the pain you can put it out of your mind easier while you wait.

hang in there

[worried A LOT]

THANK YOU SO MUCH!!
I NOW HAVE SOMETHING TO GO ON WHEN I TALK TO MY DR. AND IT SOUNDS LIKE JUST WHAT I NEED...I DON'T WANT TO FEEL FUZZY EITHER.

[dog_lover]

I agree, Tylenol is death.  Bad for the liver and in large doses it kills by destroying the liver.  Vicoprofen is perfect it has a narcotic element, hydrocodone and ibuprofen for an anti-inflammatory. If that doesn't work for you, try going one step up to oxycodone.  Do not confuse oxycodone with oxycontin, same narcotic but very different delivery method.  Five milligram oxycodone are safe and effective and come in a small enough dose that you can take an effective dose without getting groggy.  Both of the oxy drugs have no other component to foul the waters.
Dog_Lover

[worried A LOT]

CAN SOMEONE GIVE ME A DIFINITIVE ANSWER ON WITCH IS THE WORST TO TAKE WHEN YOU HAVE HEP C...IBUPROFEN OR ACETAMINOPHEN?
ARE THERE ANY MILD PAIN MEDS OUT THERE WITHOUT EITHER OF THE ABOVE??
THANK YOU ALL!

[APKhaos]

My clinical trial center is also a major liver disease center at a large teaching hospital. At the start of the clinical trial, they dosed 1000mg Tylenol 30 minutes before the first Inf shot as a preventative measre against sides.

For moderate aches, pains, fever etc., they say use Tylenol ONLY. That's what they said. Seems to clash with the 'Tylenol is Death'idea in this thread.

I'm not arguing, just presenting the instructions given by the liver disease center.

[susan400]

Since I can't take non-steroidal anti-inflammatory drugs (NSAIDS), and I can't take aspirin, my doctor said it was fine to take a nightly dose of Tylenol as long as I don't mix it with other drugs, alcohol, cold medicine, etc.  Like don't take Tylenol with another liver bad type of drug and just stick to the normal dose of Tylenol at night with my shot (when I was treating).  I'm not particularly worried about the Tylenol.  If I was taking it 4 times a day and taking a Demerol tab, or drinking a Martini with it, then I'd have some concerns about it.  I can't take the NSAIDS because it causes me to have such gastric upset that I've blood tinged throw up, so, that's more dangerous for me than Tylenol.

Susan

[dog_lover]

I'm certainly not a medical professional and I am just relaying what I have been told and read over the year or so that I have been diagnosed.  I had a friend who opted for suicide using Tylenol and in spite of heroic measures to get her a new liver she died an unpleasant death. I know you are wise enough to ignore the rantings of a pi**ed off old man who thinks Tylenol is a bigger fraud than Darvon and rely on the advice of your doctors.  My best wishes to you and I hope you thrive in a difficult situation.
Dog_Lover

[APKhaos]

My clinical trial center is also a major liver disease center at a large teaching hospital. At the start of the VX-950 clinical trial, they dosed 1000mg Tylenol 30 minutes before the first Inf shot as a preventative measure against sides.

For moderate aches, pains, fever etc., they say use Tylenol ONLY. That's what they said. Seems to clash with the 'Tylenol is Death'idea in this thread.

I'm not arguing, just presenting the instructions given by the liver disease center.

[cuteus]

I was told to use tylenol by my first hepatologist. when i told her that it did nothing for my pain, she agreed to the ibuprofen. no one can tell which one is the worse for your liver for sure, not even a dr, let alone this board.  My 2nd hepatologist mentioned that NSAIDS are more frequently associated with drug induced fulminant hepatitis than tylenol.  But if it is not going to help the pain, why use it?
perhaps you can do a web search on 'fulminant hepatitis with ibuprofen' and the same search with tylenol, and read the statistics offered and make a decission based on knowing the risks and on what works for you.

[GrandOak]

Pharmacist recommended Ibuprofen as being the easiest on the liver. However, my doc also recommended 1000 mg of Tylenol PM, particularily 1/2 hour prior to injections, as it is the best for fighting flu-like symptoms and helps sleeping (tried Ambien and it did not work at all).  When I questioned the impact to liver, I was told that as long as recommened daily dosage of 2000 mg or less is followed that there shouldn't be any problem.

Given my doc is quite experienced with HCV and head of the Transplantation Dept. at the University of Minnesota's Medical Center, I figured he must know what he's talking about.

[GrandOak]

I should possibly add that I'm stage 4 with early onset of cirrhosis with platelet counts half or third of normal.

The only caution I got beyond the recommended dail dosage limit was mixing Tylenol with other Acetometaphines and/or NSAIDS.  I was told low dosage of Ibuprofen was OK as long is it was outside of the coverage period for the dosage of Tylenol I was taking.

I've found the Ibuprofen works better for headaches and muscle pains than Tylenol for me, but none seem to help when headaches appear to be caused by anemic condition.

Given my doctors credentials in the hepatology and transplantation fields, I feel quite safe following his recommendations.

[Kalio1]

One important aspect of these OTC pain products is the amount you take. I was told they are fine, both Tylenol and Ibuprophen ( my docs prefer ibupropen) as long as you stay under the daily mg. amount. that your doctor advises for you. I was told that is 2,000mg a day for me and I have cirrhosis.
I never use Tylenol, it doesn't work at all for me.

I take less than 600mg. a day of ibuprophen and both the doc and the pharmacist said that will not cause any problems whatsoever even with low platelets. Of course, HOW low the platelets are is an issue too.  
I think anyone who takes info. off the internet, or any source, either here or from other places should then speak to their doctors about whatever the issue is FIRST before they alter their health regimen.

[APKhaos]

GrandOak said: However, my doc also recommended 1000 mg of Tylenol PM, particularily 1/2 hour prior to injections, as it is the best for fighting flu-like symptoms and helps sleeping (tried Ambien and it did not work at all). When I questioned the impact to liver, I was told that as long as recommened daily dosage of 2000 mg or less is followed that there shouldn't be any problem.


That is precisely what I was told. Stay under the 2000mg limit/24hrs and all will be well.

[tulsatime]

In my opinion. Whether or to take tylenol depends on the stage of your liver. I am stage 4. So no tylenol for me. I can't take asprin or IB prophin, because they are blood thinners. And when your bloodplatelets get lows during treatment, that would be a no no. I like the idea of the one that filters through the kidneys. I will have to keep that in mind. take care.. Debi

[tulsatime]

Thanks for the info. I was wonderong about pain IB prophin. I just assumed the was a blood thinner. My platelets are down to 49 now. Doctor is trying to cut the peg in half. But the are rethinking it and will let me know today. Talk to you later, Debi

[glow57]

Ihave had hepc for 10 years..Ihave severe pain pain everyday because of severe arthritist everywhere and fibromyalgia. My doctor has been giving me percocets 6 a day for the last 20 years. I just found out that tylenol is in percocet and it is not that great for the liver.I would like to find an alternative medication to take for the pain. thank you

[hitmanh2001]

i have tried everything and the best and safest i found was oxycodone15mg works almost allday long four me

[manda789]

what is the pain your having on your left and right sides cuase i have the same thing and im concernd i also have hep c

[mia_love]

i am 18 and i just founf out i have hcv.... im so scarred and i cant afford my medication. the pain i feel is constant and i dont know what to take im ellergic to NSAIDS.  i was told to take this vicodin. but my infectious doc. told me no tylonal and i have no family doc what do i do?

[Bill1954]

Hi Mia,

This is an old thread; you might want to start a new one by going to the top of the page, and clicking on the green ‘post a question’ button. Your thoughts will get lost down here. If you can’t afford the Hep C meds, the manufacturers might be able to help with their patient assistance programs; if you need the number I can get it to you.

Welcome to the discussion group—

Bill

[RobertBeWell]

Just to make sure I'm not misunderstanding, you do know that your liver is high on the right side of your abdomen, up towards (and maybe even partially behind) the rib cage. So, below the waistline is def not a "painful liver".

I'm probably reading your post wrong though. Just wanted to clarify.

[videobycarol]

Hi kid...

Sorry you have caught Hep C...I caught it back when i was your age too. I'm 49 now and still OK. I have never taken the treatment...tho my Dr says it would be a good idea to do it.

I just get tired sometimes and am more susceptible to catching weird illnesses that other people can fight off.

My Dr (who is a leading infectious disease specialist where I live) said chances are I will die an old lady from natural causes and not likely Hep C.

That treatment is insanely expensive...check with your local Medicaid office and see if they will cover you for it. Check with Social Services. Ask your Dr. Office for ideas. My Dr was able to get the pharmaceutical company to treat me for free...so he wants me to do it. Medicaid will also pay for it in the state I live.

As for the pain...I only have bad pain if I drink alcohol...so I dont do that anymore obviously. I get occaisional nagging pain but I dont use anything for it. My Dr. said I can use Tylenol for pain tho...just dont exceed reccomended daily adult dosage.

I know it's scary...I was very afraid when I found out I had Hep C...but it is such a long-term disease that you eventually dont think about it much...long as you dont feel too ill from it.

Try to get that treatment if you can tho...you probably have a good chance at curing it. my Dr. says I have a 50/50 chance...as i apparently have the version that is hardest to treat.

I feel so bad for you     cuz I know you must be so afraid. It is not a death sentence for most people. Really...Pamela Anderson has it...I know she's not a great role model...but she's like my age and is on 'Dancing with the Stars" and leads a pretty nice life...it's something alot of us can live with. Just listen to your Dr.

Hugs to you kid....stay safe...I'm not an expert...but I have lived with hep C for 30 years and am still alive and doing OK....so I will talk with you about it if you want  :)

[vew459]

30% of people with HepC has fibromyalgia.found in a recent new study.This condition is very painful.Also many will have a positive RA factor (arthritis) and some develope cryglobulimnia...all can cause pain attack your muscles/nerves,tendons/ligaments,joints it's all very dibilitating. Make the most of life and think quality, some docs use trileptal, nerontin, which are anti seizure meds but off label used for nerve pain. It ***** big time but can be dealable. NO ALCOHOL,NO RECREATIONAL DRUGS!!!!!!! I have seen many heppers go fast this way. DIET,EXERCISE,WATER,POSITVE THINKING,PRAYING,MEDITATION,PATIENCE<KEEP GOING!!! LIVE n be thankful u r alive!

[rute]

I was diagnosed w/Hep C 10yrs. ago. I also have esophageal varices. I live in the Bradenton/Sarasota Fla. area. I can't seem to find a Dr. to treat me. I receive SSI,& SSD. I've called around & was told that if I didn't also have AIDS that they could not treat me! I'm in the begining of cirrous too. I've had 7 blood transfusion all in a 7month span after being diognosed. I'm in alot of constant pain but, the Drs.that I have seen say because of the Hep-C they don't want to prescibe anything! I feel like there is no hope for me and I am going to die a slow painful death. Does anyone know what I can do?

[missy_jasons_girl]

I have just been diagnosed with Hep C as well as interstitial cystitis of the bladder which is known as painful bladder syndrome. Because of the hep c was told not to take any Tylenol or ibuprofen, so can anyone suggest any solution for me? I'm in constand severe pain.

[skyler411]

if your talking about minor ache and pains,that you would want to take tylenole for ,try takeing ginger root cut a couple of pieces of and boil in water a couple min to make a tea ,,you'll need to sweetin it a little w/ hunny or watever u like to use for sweetener and drink up I SWEAR BY THIS! IT really works for most minor pains !! I haven't used tylenole or anything like it in a few yrs now gingerroot is a natural pain reliever and i believe its good for your liver as well
                              -julie

[skyler411]

that last thread was ment for you ,,sorry just tired ,but if  you try the gingeroot i hope you get some relief
           -julie:)

[portann]

Hi Julie,

I see Missy also started her own thread here and got some great responses:

http://www.medhelp.org/posts/Hepatitis-C/pain-help/show/1332382

It usually works better to start a new thread than bring up an old one.

You may want to add your comment to her new thread.

[Pharmacist7350]

I am a pharmacist, and would suggest staying away from both ibuprofen and acetaminophen (Tylenol) if you have hepatitis.  Unfortunately, the only way to treat the pain in a hepatic patient is to use narcotics which are eliminated from the body by the kidneys.  Im opinion, the literature points more toward mild doses of ibuprofen being better tolerated than Tylenol in hepatitis, so a good option to discuss with your physician is hydrocodone/ibuprofen (Vicopofen).  Keeping the dose low and the interval to no more than 3 times a day will help with the pain while still keeping you from experiencing too many sedating side effects.  Mild doses of Vicoprofen are also minimally habit-forming.  Be sure to take it with food if you get a prescription for it.  I hope this information helps!

Alex, Pharm.D.

[Trinity4]

Acetaphetamine (no more than 2000 mg in 24 hrs) is recommended by most hepatologists.  Those with cirrhosis are can also take acetaphetamine but should consult with their doctor for the recommended dosage.  I have advanced liver disease and I don't know what you mean by hepatic pain.  I've never experienced that.  The liver has no nerves.
The capsule surrounding the liver can expand if the liver enlarges producing intermittent pain at times but those with liver disease do not experience pain for the most part.

Trinity

[Bill1954]

Jorge L. Herrera M.D.
Division of Gastroenterology
University of South Alabama College of Medicine
Mobile AL

http://www.hcvadvocate.org/hcsp/articles/Herrera.html

“Acetaminophen use: Contrary to popular belief, acetaminophen (the active ingredient in Tylenol®) is perfectly safe for patients with cirrhosis as long as it is used cautiously. Any person who drinks alcohol regularly should not consume any acetaminophen. For patients with early cirrhosis (CPT class A or B), the use of acetaminophen is safe as long as the recommended dose is not exceeded (1,000 mg per dose, repeated no more often than every 6 hours). Patients with more advanced cirrhosis should take only ½ of the recommended dose. In fact, for patients with cirrhosis, acetaminophen, when used as described, is the preferred medication for the treatment of pain.”

[Fnzol]

"I am a pharmacist, and would suggest staying away from both ibuprofen and acetaminophen (Tylenol) if you have hepatitis.  ... Im opinion, the literature points more toward mild doses of ibuprofen being better tolerated than Tylenol in hepatitis "

My doc and case nurse are firm about avoiding ibuprofen, but they say that even a damaged liver can metabolize 3 grams/per day acetaminophen.  They limit the dose to 2 grams, however, for those us in the program.  I take it for bone pain from Neupogen and for the slight leg cramps from the INF.  

[Trinity4]

" I take it for bone pain from Neupogen and for the slight leg cramps from the INF."

I took it for the pain from Neupogen as well.  72 weeks to be exact.  Hmm, wonder how my liver damage managed to regress a stage with all that Tylenol?  :)

Trinity

[James10500]

So much conflicting advice.  My doc told me...lol. Ibuprofen was fine to take, as long as it isn't over 800 mg a day.  The guy is the head of one of the largest liver transplant centers in the country, and has published over 300 papers on liver issues.  I'll have to take his word for it.

[Bill1954]

I think some of this is contingent upon degree of fibrosis; as patients become cirrhotic, platelets can drop precipitously, and blood clots poorly. Aspirin and ibuprofen can exacerbate that; you’re doctor likely advised you based on your personal history?

--Bill

[James10500]

Good point it may not be the advice he gives to everyone.

I've been of meds now for two weeks tomorrow, and like you experienced feeling much better at two weeks.  Good call.

[Bill1954]

What a difference a couple of weeks makes, huh? After both treatments I had lab orders at thirty days post; everything had normalized at that point; red cells, white cells, platelets, etc. The first time, the only thing that was off was viral load, which unfortunately had returned. Hopefully you won’t share that experience with me :o).

Good luck, James—

-Bill

[merryBe]

here's what I know to be true, a pharmacist has 6 years of training in drug reactions and interactions, a physician has 1 year only.

One vs. 6...hmmm... who should we listen to...my vote is a pharmacist!!!

Also the verdicts are clear one that one has to look at the whole patient profile.
Toxicity is common with tylenol, even in children, certainly in sick livers, and unless one was early stage and no conflicks with ones P450 profile....but then only a good pharmacist even knows about that stuff...even though more stuff comes out every year at the AASLD doctors still resist converting from their tylenol brainwashings, as do patients.

ibuprofen and anti-inflammatories can lead to thinning of the stomach wall, and contribute to esophageal varicies as well as increased internal liver blood pressure. Since a sick liver can have pressures several times above normal why  go there, why make that worse.

We are better off to use narcotics, only because they do the most good with the least amount of enyzme elevation. Tramadol raises enyzmes as do many "alternatives" to true opiods. However, opiods are safer, and docs will prescribe them as long as the patient doesn't abuse them.

BTW, Right quadrant pain is very common in latter stage liver disease, not because the liver itself is in pain, but the inflammation caused by sepage (seepage) and enlargment leave many with serious side pain.

[sweetone201]

i was just diagnosed for hep c i am very scared...dont know what to think what to do..im 38 years old got it through sexual intercourse..im in alot of pain few inches below my back around to left and right side abdomen area waiting on dr. appt.. tylenol made me sick  ive took a pain killer from time to time im not much for them...im also a high blood pressure high cholesterol patient and bad anxiety...got lied to *****..ive read all your guys advice and it made me feel better..what really is good to take for the pain and how do you live with it...im a single mother now was engaged and he was the one i got it from...not my ex husbands...he cares but yet doesnt seem to think its a big deal he has had it for a long time and never been treated. he didnt tell me till after we had intercourse and i freaked he said i couldnt get it through sex my doctor said yes you can was tested and positive and only been with the guy a year. from down sad and depressed:(

[willbb]

Hi there ....It would be better if you have a question to go to the  green " post a question " area at the top  and start your own thread there,more people will see it that way and respond.

Sorry to hear of your diagnosis ...however ,first of all are you sure you have active Hepc? Was the test they did just for the antibodies (in which case you may or may not have active infection ) or did they do a PCR test to definitely test for Hepc.

Also ..if you do have Hepc ..it is for the most part a very slow moving disease that usually takes many years and often decades to do any damage.. and for the most part there is usually no symptoms and very rarely is pain one of those symptoms

So..for now you need to find out what blood test they ran to  ascertain if you have HCV and   if so  ... then be referred to a hepatologist or a gastroenterologist to  do some further tests..(ie genotype and possibly a biopsy)

The new treatment avail. today is in the vicinity of 75% successful..., and in the meantime  a good idea to read up on HCV...   link below.

Good luck ..and welcome
Will

.http://www.hivhepsti.info/documents/HCVnewlydiag.pdf

[cherylyn779]

I've read all the comments here & want to say thank you!! I woke up at 4:00 am with severe liver pain... it really helped to read everyones stories...

[DrDAwn]

The liver must have adequate reserves of glutathione to detoxify Tylenol/acetaminophen. The safe level of Tylenol is specific to each individual--ie, one that does not exceed one's reserves of glutathione. (Glutathione is the "antidote" used in E.R.s when one takes an overdose of acetaminophen.)  One can take glutathione, but it doesn't absorb well.  The precursors to making glutathione are n-acetyl cysteine, glycine, and glutamic acid (these are amino acids--the building blocks of protein).  Usually n-acetyl cysteine is the limiting factor, so all three are not necessary.  Interestingly, one's glutathione levels are one of the most reliable predictors of longevity.  Generally, a good quality UNDENATURED whey protein will provide the necessary amino acids to make glutathione.  My patients use Standard Process "Whey Pro Complete", but there are others available.  A more expensive, but effective product is Immunocal.  I also met a woman whose Hep C is now undetectable after taking glyconutrients from Mannatech (an MLM).  Same type of glyconutrient product (less expensive, and I'm told just as good) is sold as MPS Gold from Dr. David Wheeler's site. Glycoproteins are normal components of cell membranes that are involved in proper cell-to-cell communication.  This has obvious implications, including immune function, detoxification, and many other cell functions.  They are essential to health, but are especially crucial to those who have compromised health.  I would also use Lauricidin, which selectively inhibits pathogenic bacteria, fungi, and viruses.  One must begin with just a few pellets and can then increase gradually to several mini-scoops per day. The great thing about these options is that they promote a healthy immune system and healthy function of cells in general--and without negative side effects or interference with drugs.   Everything I have mentioned is also available without prescription.

[alice469]

IVE FOUND THAT TAKING 15MG OF OXYCODONE HCL WHICH DOESNT HAVE ANY ASPIRIN, ACETAMINOPHEN, OR IBUPROFEN(NSAIDS) JUST 15MGS OF PERCOCET(OXYCODONE) TWICE PER DAY DOESNT AFFECT THE LIVER IN PATIENTS WITH CHIRROSIS (cirrhosis) OF THE LIVER, LIVER CANCER, AND/OR HCV AND ALSO KILLS THE PAIN TO THE POINT OF MANAGABILITY TO WHERE YOU MAY CONTINUE AS YOU WOULD NORMALLY HAD YOU NOT BEEN IN PAIN IN THE FIRST PLACE! GOOD LUCK AND MAY GOD IN HEAVEN BLESS US ALL!