hep c and paracetomol

[calmblueocean]

Hi,
been on interferon/ribavirin a bit over a week now. Minimal side effects thus far; counting my blessings. Have had a couple of headaches which is par for the course, which brings me to a question. Re headaches; the nurse tells me paracetomol is fine to deal with headaches and fever. However, I seem to recall the advice in the 90's for people with HCV was for them not to take products with paracetomol in them because they were hard on the liver. I have to say I've tended to use disprin/aspirin instead of paracetomol over the last 10 years because of this advice. Does anyone have any info about this topic

[charm27]

Yes iit is no good for the liver it can cause liver damage too. Anthing that is ingested is filtered thru thru the liver. I was told my my hepatologist if needed you can take 4 Tylenols a day if absolutely necesary. Or an aleve occasionally.

[desrt]

Paracetomol is basically the same thing as acetominophen and the same guidelines apply. Ask your doc which type of anti-inflammatory you should be on - NSAID (aspirin, ibuprofen, naprosyn) or paracetomol/acetominophen type (i.e. Tylenol). I used both while on treatment. If your doc O.K.s para' he will probably tell you to keep it under 2000-3000 mg/day - that's the usual guideline for patients with liver disease. Doctors in the '90s were much more concerned with this than they are nowadays. Most of the toxicity problems came from people using excessive amounts - 3000+ mg/day.  

[calmblueocean]

If paracetomol is essenially unhealthy for the liver, why do drs recommend it a opposed to aspirin? Why don't they just recommend aspirin as the general medication for fever, headaches etc? Seems to me that they are saying 3000+mgs of paracetomol daily is bad for you; wouldn't it be better to not use this medication at all?
Thanks for your feedback.

[desrt]

It very much depends on the individual which type of anti-inflammatory does less damage. That's why I say, #1 ask your doctor. A person with gastric problems or varices might not be able to tolerate aspirin or other NSAIDs, while I understand someone with cirhosis can stand up to 1000 mg/day of para'. I believe moderation is the key and being able to switch between the two types was a huge help to me.

[Marcia2202]

Below is what I found on pain relief meds. They are all bad for the liver. I guess the doctors have weighed out all the options and prescribe what makes the least damage to the liver for the specific individual. In Denmark they prescribe paracetamol at the beginning of tx. Personally, if I can still take the headache, I will not pop a pill. I tend to drink extra water and take a nap. Often I just go around with a headache or a migraine. Have always done that, unless it gets really bad. I haven't started tx, yet, so I don't know what I will be doing then, but I think it's best to stay away from any additional meds, if one can.

The primary over-the-counter painkillers contain acetaminophen, ibuprofen or aspirin. All three of these have some impact on the liver, and can cause liver damage when taken in excess. While occasional, restricted use may be safe for those with Hepatitis C, a doctor will choose the drug based on which is least likely to adversely affect you.

1. Acetaminophen – (Tylenol, Anacin 3, Panadol, Paracetamol and others) is a common, mild to moderate pain reliever and fever reducer. A liver afflicted with Hepatitis C may not be able to metabolize this drug. High doses of acetaminophen can cause liver injury, even to a healthy liver. In limited dosages, a physician will generally only suggest this class of analgesic to a person whose hepatic metabolism is fully functioning.

2. Ibuprofen – (Motrin, Advil, Nuprin and others) reduces high body temperature, is an anti-inflammatory and inhibits normal platelet function. A non-steroidal anti-inflammatory drug (NSAID), ibuprofen can cause gastrointestinal upset and bleeding. Those at risk of portal hypertension are already at risk for gastrointestinal bleeding, intensifying this risk. Studies have demonstrated that at certain dosages, ibuprofen can stress the liver and elevate liver enzymes in people with Hepatitis C. Ibuprofen must be used with extreme caution in the later stages of liver disease and for those on interferon therapy.

3. Aspirin – (Bayer, Anacin, Excedrin and others) reduces fever, relieves pain, and acts as an anti-inflammatory and blood thinner. In addition to influencing liver test results, aspirin’s effect on blood platelets temporarily limits the clotting process and prolongs bleeding. In chronic liver disease where the body’s production of clotting factors is naturally decreased, aspirin can increase the risk of bleeding. Although there is no actual drug interaction between aspirin and the drugs used in interferon therapy, both can disrupt blood clotting, which must be monitored if used together. When taken in high doses (more than 2,000 mg per day) aspirin can cause liver injury.