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

[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.  

[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.”

[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

[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.

[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.

[skyler411]

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