What Medications Commonly Given in the Acute Care Setting Are Safe in Liver Failure and Cirrhosis? In What Doses?

  • Amber RuestEmail author


No evidence-based guidelines exist for the use of medication in patients with liver cirrhosis; however based on drug pharmacokinetics, many medications require dosage adjustment. Acetaminophen can be used safely at low doses (≤2–3 g daily) for short durations and should be considered first-line treatment for pain as opioids can precipitate hepatic encephalopathy. Nonsteroidal anti-inflammatory drugs should be avoided as they predispose to renal failure and gastrointestinal bleeding in this population. Opioids and sedative medications should be avoided, and, if necessary, they should be given with reduced dosage or frequency. Cirrhotic patients may take prophylactic medications, and acute care providers should understand the potential for associated adverse effects.


Medications Acetaminophen Ibuprofen Hepatotoxic Dosing Cirrhosis 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Emergency MedicineWellspan York HospitalYorkUSA

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