It depend on how damaged your liver is. Patients with cirrhosis are recommended to take Tylenol ONLY. Acetaminophen is a medication used to control pain (known as an analgesic) and fever (known as antipyretic). When taken at recommended doses, acetaminophen, the medicine in TYLENOL®, is the preferred pain reliever for patients with chronic, stable liver disease.
Do not use TYLENOL® with other acetaminophen-containing products. Always read and follow label directions. Taking more than the recommended dose (overdose) of acetaminophen may cause liver damage. In small doses (less than 4 grams per day, or eight pills taken over a twenty-four hour period of time) acetaminophen is quite safe for the liver—unless combined with alcoholic beverages.
Acetaminophen is the recommended medication for relieving minor aches, pains, and headaches in people with liver disease.
NSAIDs - people with advanced liver disease are advised to totally avoid all NSAIDs such as aspirin, Ibuprofen, etc.
NSAIDs presently on the market that have been frequently associated with liver injury are aspirin (ASA), diclofenac (Voltaren), and sulindac (Clinoril). Ibuprofen (Motrin) has been reported to cause severe liver injury in people with hepatitis C.
It is recommended that people with liver disease avoid using all NSAIDs. If NSAIDs are medically required for the treatment of another medical disorder, a reduced dose should be used for a limited period of time and only by people with stable liver disease. Older women with liver disease seem to be particularly susceptible to the hepatotoxicity of NSAIDs and are advised to avoid NSAIDs altogether. Since NSAIDs may cause salt and water retention people with fluid retention problems such as ascites or leg swelling may suffer worsening of these conditions. People with decompensated cirrhosis are at increased risk kidney damage stemming from the use of NSAIDs. Since this may lead to hepatorenal syndrome, people with advanced liver disease are advised to totally avoid all NSAIDs. Furthermore, people with ascites (fluid accumulation) may not respond to treatment with water pills (diuretics), while on NSAIDs, as they counteract their actions. ( see chapter 20). People with liver disease who have had internal bleeding, - from an ulcer or esophageal varices, for example, may be at risk for recurrent bleeding induced by NSAIDs, and should totally avoid this class of medications. People who are also taking corticosteroids (such as prednisone), or anticoagulants (such as coumadin) may have and increased risk of complications from NSAIDs. Finally, people with liver disease who smoke cigarettes or drink alcohol should avoid NSAIDs as they are also at increased risk for its complications.
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