Medications
Key points
- Your doctor might give you different medicines, depending on your condition
- This page lists common medicines that are used for people whose liver disease is more advanced (cirrhosis)
- People with liver disease need to be very careful about which medicines they take and how much, including medicines for other health conditions
- Always talk to your doctor about all medicines or supplements you are taking or want to take, including herbal medicine
Managing medicines with liver disease
Medicines for hepatic encephalopathy
Hepatic encephalopathy (HE) is a complication of advanced liver disease or acute liver failure. Symtpoms include confusion or short-term memory problems. Other symptoms may include feeling tired, tremors or having difficulty carrying out simple tasks.
Medications
Lactulose: A sweet syrup-like medicine. It’s a laxative that helps the body to remove toxins that can build up when the liver is failing. It also helps to prevent the growth of bacteria that produce ammonia in the bowel, which can affect brain function. It is important to have at least 2 to 3 bowel movements per day to prevent toxin build-up in liver disease.
Rifaximin: Helps to prevent infections and remove toxins from building up in the body when the liver is not working well.
Medicines for ascites or peripheral oedema
Ascites (fluid building up in the tummy) and swelling in the ankles or legs (peripheral oedema) can be a common complication of cirrhosis. Ascites can be uncomfortable and may cause difficulty breathing. You should check your weight on the scales at home twice a week. Your doctor will give you a plan for adjusting your fluid tablets if your weight goes up or down too much.
Medications
Spironolactone and Furosemide: Also known as diuretics or fluid tablets. These medicines help the body get rid of excess fluid.
Carvedilol: Helps to stop your body from building up ascites.
Antibiotics such as Trimethoprim+Sulfamethoxazole (Bactrim or Resprim) or Norfloxacin: Antibiotics that may be used if the fluid building up in the tummy (ascites) becomes infected; antibiotics are used to help treat the infection or may be used to prevent infection.
Medicines for portal hypertension and variceal bleeding
Portal hypertension is a complication of advanced liver disease. It means there is high pressure in the portal vein, the vein that carrieds blood into the liver. Sometimes portal hypertension can cause internal bleeding.
Medications
Propranolol and carvedilol: Known as beta blockers, they reduce the risk of bleeding from varices (expanded blood vessels) by helping lower the high blood pressure in portal vein). They can also help reduce the risk or severity of bleeding.
Steroids
Prednisolone: This is a steroid that can help to reduce some causes of inflammation in the liver. Do not stop taking steroids unless asked to by your doctor, because this can be dangerous. Steroids should be slowly reduced then stopped. It is best to take this medicine with or after food.
Calcium and vitamin D supplementation: Can be prescribed for bone protection whilst taking a course of steroids and can be stopped when the course of steroids has been completed.
Vitamins
Thiamine: A vitamin B1 supplement that helps supplement for vitamin B1 deficiency. People who drink too much alcohol often have low vitamin B1.
Multivitamin: Helps to provide support for vitamin deficiencies. Vitamin deficiency is often common in liver disease.
Side effects
All medicine can be associated with side effects. For more detailed information, refer to the leaflet provided by the manufacturer in the medicine package or speak to your doctor.
Important notes on taking your medication
- It is important that you take all your regular medicines at the right time.
- If you miss a dose, take the next one as soon as you remember, but do not take a double dose unless you are told to do so. If there is a problem or you forget more than one dose, ask your doctor or pharmacist for advice.
- Most medicines used in people with cirrhosis are long-term medicines and should not be stopped suddenly. Make sure you have enough supplies of your medicines, particularly over public holidays or if you plan to travel. Order repeat prescriptions well in advance in case the pharmacy runs out of stock.
- If starting any new medicine (including over the counter medicine), always check with your community pharmacist or GP if it is safe with liver disease.
We have published a booklet on common medicines for cirrhosis.
Download the booklet
The information on this page is courtesy of the Royal Prince Alfred Hospital, Sydney.