Are OTC Analgesics Safe for Patients with Cirrhosis?

Occasional low doses of acetaminophen seemed to be safe; the case for NSAIDs was less clear.

Acetaminophen-associated hepatotoxicity from massive ingestion of the drug or from chronic therapeutic use over time is the most common cause of acute liver failure in the U.S. Whether over-the-counter (OTC) analgesics, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), are safe for patients with cirrhosis is unclear. In a case-control study partially supported by the maker of Tylenol, researchers evaluated the role of OTC analgesics in precipitating acute decompensation of cirrhosis.

The study involved three groups of patients: (1) cirrhotic cases: 91 consecutive patients with cirrhosis who were hospitalized for acute decompensation (variceal hemorrhage, new or worsening ascites, encephalopathy, jaundice, renal dysfunc…

Reviewing Author

Atif Zaman, MD, MPH