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. 2010 Dec 29:26–455. doi: 10.1016/B978-0-443-07151-5.50005-6

Table 3.100.

Drugs contraindicated and alternatives in patients with liver disease

Drugs contraindicated Alternatives
Analgesics

  • Aspirin

  • Codeine

  • Indometacin

  • Mefenamic acid

  • Meperidine*

  • NSAIDs

  • Opioids

  • Paracetamol/acetaminophen*

  • Codeine

  • Hydrocodone

  • Oxycodone
Antimicrobials

  • Aminoglycosides

  • Azithromycin

  • Azole antifungals (miconazole, fluconazole, ketoconazole, itraconazole)

  • Clarithromycin*

  • Clindamycin*

  • Co-amoxiclav*

  • Co-trimoxazole

  • Doxycycline

  • Erythromycin estolate

  • Metronidazole*

  • Roxithromycin

  • Talampicillin

  • Tetracycline

  • Amoxicillin

  • Ampicillin

  • Cephalosporins

  • Erythromycin stearate

  • Imipenem

  • Minocycline

  • Nystatin

  • Penicillins
Antidepressants Monoamine oxidase inhibitors

  • SSRIs

  • Tricyclics*

Muscle relaxants Suxamethonium

  • Atracurium

  • Cisatracurium

  • Pancuronium

  • Vecuronium
Local anaesthetics Lidocaine*

  • Articaine

  • Prilocaine
Anaesthetics

  • Halothane

  • Thiopentone

  • Desflurane

  • Isoflurane

  • Sevoflurane
Central nervous system depressants

  • Barbiturates

  • Diazepam*

  • Midazolam*

  • Phenothiazines

  • Propofol*

  • Lorazepam*

  • Oxazepam*

  • Pethidine*

Corticosteroids Prednisone Prednisolone
Others

  • Anticoagulants

  • Anticonvulsants

  • Biguanides

  • Carbamazepine

  • Diuretics

  • Liquid paraffin

  • Lomotil

  • Methyldopa

  • Oral contraceptives
*

Or use in lower doses than normal.