Opiates are also broken down by the liver and this process can cause even worse side effects, such as serious mental confusion in patients with liver dysfunction.Īnother class of pain relievers is non-steroidal anti-inflammatory drugs, or NSAIDs. Patients are told to avoid opiates like oxycodone because they can be addictive or have undesirable side effects such as constipation and sedation. What about opiates and NSAIDs?įor those with chronic liver disease, options for a safe and effective pain reliever are limited. Because of this, liver injury from acetaminophen is considered an “all-or-none” phenomenon that is, either the patient doesn’t recover and needs a liver transplant to survive, or there is complete recovery without long-term liver damage. Most patients who receive NAC within 24 to 48 hours of an overdose of acetaminophen get better, and even those who progress to liver failure usually recover without the need for a liver transplant. This drug is called N-acetylcysteine, or NAC. And when acetaminophen does cause liver injury, there is an effective antidote that can reverse the damage if started early. It’s unlikely that taking acetaminophen over time causes chronic liver disease or cirrhosis. But the toxic byproducts can accumulate, so it’s best not to take acetaminophen every day. Staying within these limits will generally prevent liver injury. The good news is that liver injury can be avoided by limiting the amount of acetaminophen taken each day to 3,000 mg for most people and 2,000 mg for those with chronic liver disease. In fact, acetaminophen is the most common cause of acute liver failure in the United States, accounting for almost half of all cases. If anyone takes too much, even those with healthy livers, it will reliably cause an acute injury to the liver. The dose is the keyĪcetaminophen is a dose-dependent hepatotoxin, which means that its toxic effects on the liver are related to the amount taken. When acetaminophen is broken down, it can form byproducts that are toxic to the liver, so this warning is not completely without merit. Still, experts say that acetaminophen is the best option for pain relief for people with liver disease. Patients with liver disease are often told that they shouldn't use acetaminophen, a common over-the-counter pain reliever found in Tylenol and many other cold and flu medications.
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