LIVER-SAFE PAIN MEDICATION?

[worried A LOT]

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

[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 and enlargment leave many with serious side pain.

[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

[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]

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]

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.

[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