What Pain Medication Is Safe With Liver Disease?

Living with chronic pain can be debilitating, and it's crucial to find a way to help alleviate your symptoms without causing further damage to your body. 

Those who suffer from liver disease must take extra precautions when selecting a pain reliever. This is because the liver processes many medications, and some pain relievers can cause additional liver damage. In addition, there are some that aren’t safe when the liver is unable to process them. 

This post explores the various pain medications available for liver disease. The first step is to understand what your liver does. 

Liver functions explained

The liver is an essential organ in the human body. It performs many vital functions, from synthesizing proteins to detoxifying your blood. Let's take a closer look at the liver and some of its functions. 

What is the role of the liver in the body?

The liver has a range of essential roles in the body. It processes nutrients from food, produces bile for digesting fats, stores various vitamins and minerals, and processes toxins in your bloodstream. The liver also helps to regulate hormones, synthesize proteins needed for blood clotting and transporting substances in the bloodstream, and maintain proper glucose (blood sugar) levels in your system. 

How does the liver synthesize proteins? 

Proteins are essential components of our cells and play an important role in nearly all biological processes. All cells in the body are capable of making proteins, but different types of cells make different specific proteins. The cells of the liver are specialized for making a wide variety of proteins that are extremely important for the body’s ability to function. 

To build proteins, cells use amino acids, which can be sourced from food or recycled from old proteins that have been broken down by the body.

The role of the liver in detoxification

The liver processes harmful chemicals that enter your bloodstream through food or other sources, such as pollutants or drugs. It breaks down these toxins so that they can be safely eliminated from your body via your urine or feces. 

What causes liver pain?

Before starting any treatment for liver pain, the first step is to determine what is causing the discomfort. Some common causes of liver pain include viral hepatitis, fatty liver disease, cirrhosis, and gallstones. 

Depending on the underlying cause of your liver pain, some treatments may be more effective than others. It is always best to speak with a healthcare provider before starting any sort of treatment for your condition. 

What medicine for liver pain is available?

Pain in the area of the liver (the upper right part of the abdomen) can be a symptom of several conditions, ranging from mild to severe. If you experience liver pain, consult your doctor to determine the cause and best treatment. 

Sometimes, your doctor may recommend taking medications as part of your treatment plan. Let's take a look at some of the medications that may be used to treat liver pain. 

Acetaminophen (Tylenol) 

Acetaminophen is one of the most commonly recommended medications for reducing liver pain. It works by blocking specific chemical reactions in the body that cause pain and inflammation. 

Compared with other over-the-counter pain relievers, acetaminophen is less toxic to the liver and also tends to have fewer major side effects in other organ systems. However, it should still be taken cautiously, as large doses can damage the liver over time. 

Antispasmodic medications 

If your liver pain is caused by spasms in the bile ducts or gallbladder, antispasmodic medications may be prescribed to help relieve this type of discomfort. 

These medications work by relaxing muscles around the bile ducts and gallbladder, reducing painful spasms and allowing bile to flow more normally. Common antispasmodics used for treating liver pain include dicyclomine hydrochloride (Bentyl), hyoscyamine sulfate (Levsin), and hyoscine butylbromide (Buscopan).

Alternative treatments for liver pain 

In addition to traditional medications, there are also some alternative treatments that may help ease symptoms associated with liver diseases, such as fatigue and nausea. 

Herbal remedies like milk thistle or burdock root have been used for centuries as natural treatments for various ailments related to the digestive system, including those related to the liver. 

Although there is some scientific evidence that certain herbal medicines may have benefits for the liver, it’s also important to be cautious. Some herbal medications can cause liver damage. Just because a medication is natural doesn’t mean that it’s safe. It’s best to talk to your doctor about any herbal or natural treatment you’re considering to ensure that it’s safe for you.

Additionally, acupuncture has been shown to reduce levels of nausea in patients suffering from chronic illnesses, such as cirrhosis or viral hepatitis. Acupuncture is generally recognized as safe when performed by a licensed acupuncturist, although it’s still better to discuss it with your doctor first.  

Which painkiller is safe for the liver?

Acetaminophen, also known as paracetamol and commonly sold under the brand name Tylenol, is generally the recommended analgesic in patients with liver diseases like cirrhosis. This is because paracetamol, when given in recommended doses, has a proven safety profile. It also doesn’t produce sedative effects, isn’t toxic to other organs (like the kidneys), and doesn’t carry a risk of addiction.

The recommended maximum dosage for acetaminophen is reduced in people with liver failure. A patient with liver disease should take a maximum total dose of 2–3 grams per day. By contrast, in people with healthy livers, up to 4 grams per day is considered safe. Keep in mind that the dose of acetaminophen is usually measured in milligrams — 2 grams is 2,000 milligrams. Overdose of acetaminophen can cause liver failure, so it’s important to ensure you stay within the safe range.

Other over-the-counter painkillers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are generally considered unsafe for people with liver failure. They can cause liver damage and also carry a risk of major side effects, including kidney damage and bleeding in the digestive tract. This group of medications includes common drugs like ibuprofen and naproxen.

Opiates are also considered to be less safe in people with liver damage. Because the liver normally clears opiates from a person’s bloodstream, it’s easier for people with liver failure to overdose. In addition, opiates can lead to hepatic encephalopathy, which can have severe effects on the brain. 

Because opiates also carry a high potential for addiction, it’s important to be careful with them in all patients, including those with liver failure. Although doctors do sometimes prescribe opiates to people with liver failure, they’re generally only used if there are no other effective options.

Remedies for improving liver health

The liver is an essential organ that performs many vital functions, from clearing toxins from the bloodstream to storing energy reserves. When your liver isn't functioning correctly, it can lead to serious health complications. 

There are certain lifestyle choices that can have an impact on your liver health.  

Eat liver-friendly foods

Eating a healthy diet is one way to help your liver stay healthy. High levels of added sugar, especially from soft drinks, are associated with damage to the liver. Saturated fat, especially from red meat, may also be harmful.

Eating unsaturated fats, found in nuts, seeds, and fish, may help keep your liver healthy. Dietary fiber, which is found in fruits, vegetables, and whole grains, may also be good for liver health.

Exercise regularly

Exercise has been found to be beneficial for liver health. Exercise helps keep your heart and other organs healthy and strong, which in turn helps keep your entire body healthy. It also helps reduce stress levels, which can positively affect your liver health. 

Aim to get at least 150 minutes a week of aerobic exercise (such as walking, running, or dancing — anything that raises your heart rate and gets you slightly out of breath). This is about 20 minutes per day on average. In addition, try to do resistance training (lifting weights or using resistance bands) twice a week. 

Use alcohol responsibly

When the liver processes alcohol in your bloodstream, certain toxic compounds are formed that cause damage to the liver. Over time, this can cause inflammation in the liver and lead to cirrhosis, in which large amounts of scar tissue form in the liver and interfere with its function. Cirrhosis can be fatal.

Just two to three drinks per day for ten years is enough to cause alcoholic liver disease. If you choose to drink alcohol, it’s best to minimize how much and how often you drink to protect your liver.

When to contact a doctor

It’s best to see your doctor regularly. In most cases, a checkup will include tests of your liver function, and your doctor will look for signs of possible liver disease as part of a routine physical exam. This allows your doctor to identify and treat any underlying liver conditions as early as possible. 

If you notice any possible signs of liver damage, making an appointment with your doctor is the best course of action. Your doctor will evaluate your condition and recommend the most appropriate treatment plan.

The lowdown

When it comes to managing pain while living with liver disease, it's essential to understand which medications are safe and which ones should be avoided entirely or used in lower doses than usual. 

Acetaminophen is often considered the safest pain relief option for people with liver disease. However, the dose may need to be adjusted to prevent additional liver damage. If you have liver disease, consult your physician before taking acetaminophen so you can get personalized recommendations. Acetaminophen can still cause side effects but is safer than other options.

If you have liver disease, non-steroidal anti-inflammatory drugs like ibuprofen and naproxen should be avoided unless your doctor prescribes them, as they can cause further damage to the liver when taken in large doses or over long periods. 

Try to speak openly about any concerns you may have about pain management when talking with your doctor so that you can find the best treatment plan for your individual needs and lifestyle. Don’t be afraid to tell your doctor you’re experiencing pain and would like help managing it.

Frequently asked questions

What painkiller does not affect the liver?

Acetaminophen (paracetamol), when taken in reduced doses (maximum 2–3 grams per day), is generally considered to be the safest pain relief option for your liver. However, high doses may cause liver damage, so it’s important to stay under the safe limit.

Can you take opioids with liver problems?

People with liver disease should use opioids cautiously. They can cause a sudden worsening of encephalopathy (which affects the brain) and can also cause other side effects, such as constipation and sedation. Because the liver normally clears opioids from the bloodstream, people with liver damage can overdose more easily.