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. Author manuscript; available in PMC: 2019 Nov 1.
Published in final edited form as: Liver Int. 2018 Jun 19;38(11):1882–1890. doi: 10.1111/liv.13892

Table 1.

Commonly used Medications and Adverse Effects in Cirrhosis

Medication Class Indication Take Home Point Adverse Effects
NSAIDs Acute and chronic pain Readily available and often prescribed first line, but should not be used in the presence of ascites50

  • AKI

  • Gastrointestinal bleeding
Acetaminophen Lower daily dose (≤ 2000 mg daily) is safe to use51 and preferred first line pain medication

  • Acute liver injury/failure with higher than recommended doses
Narcotics Commonly prescribed (19–60% of patients)52,53

  • Constipation

  • HE

  • Drug dependence
Proton Pump Inhibitors GERD, PUD, dyspepsia Long term PPI use is often not indicated, up to 63% of patients are continued on a PPI indefinitely after a variceal bleed23

  • Potential association with Spontaneous Bacterial Peritonitis, HE10,25

  • C. difficile infection26
Statins Cardiovascular risk reduction Statins have been shown to be safe in compensated cirrhosis and should be continued as clinically indicated. Recent studies suggest they may be beneficial in patients with cirrhosis 54,55

  • Elevated liver enzymes (only clinically significant if bilirubin is elevated, which is rare)54

  • Myalgias

NSAIDs: Non-Steroidal Anti Inflammatory Drugs

AKI: Acute Kidney Injury

HE: Hepatic Encephalopathy

PPI: Proton Pump Inhibitors

GERD: Gastroesophageal reflux disease

PUD: Peptic ulcer disease