The information provided here is meant to give you a general idea about each of the medicines listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medicines as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Although cirrhosis cannot be cured, your doctor may prescribe several medicines to treat your cirrhosis. These drugs may help control the cause of the cirrhosis and prevent additional liver damage. Or they may be aimed at treating symptoms and complications.
Vitamin K: Phytonadione (AquaMEPHYTON, Mephyton)
Diuretics: Bumetanide (Bumex)Furosemide (Lasix)Hydrochlorothiazide (HydroDIURIL, Esidrix)Chlorothiazide (Diuril)Amiloride (Midamor)Triamterene (Dyrenium)Spironolactone (Aldactone)
Bleeding from Varices: Octreotide
Antihypertensives (Beta-blockers): Atenolol (Tenormin)Metoprolol (Lopressor)Nadolol (Corgard)Propranolol (Inderal)Timolol (Blocadren)
Laxatives: Beta-galactosidofructose (Lactulose)
These three drugs are FDA approved for the treatment of alcohol abuse. If you drink while on disulfiram, you will experience a negative reaction or hangover symptoms which are far worse than the usual hangover symptoms. These symptoms might include: headache, nausea, confusion, and uneasiness. Naltrexone reduces the craving for alcohol. Acamprosate reduces both the physical and emotional distress associated with quitting drinking, such as less sweating, sleep disturbance, and anxiety.
Possible side effects associated with these alcohol abuse drugs include: DrowsinessErectile dysfunctionHeadacheMood changesPeripheral neuropathyPsychosisAbdominal crampsDermatitisInsomniaMuscle painRashVomitingDiarrheaIntense itching
Common names include: Alpha-Interferon
(Alferon N, Roferon-A, Intron A)Peginterferon (Pegasys)Ribavirin
(Epivir, Epivir-HBV)Tenofovir (Viread)Adefovir (Hepsera)Entecavir
Chronic viral hepatitis B and C may respond to treatment with antiviral medicines. These may include interferon for hepatitis B and C. A combination of interferon and ribavirin is used for hepatitis C.
For hepatitis C, combination therapy consistently yields higher rates of sustained response compared to treatment with just one drug. Interferon is given subcutaneously once every week. Ribavirin is an oral antiviral agent that is given twice a day.
Lamivudine, tenofivir, adefovir, entecavir, and telbivudine are used to treat hepatitis B infection. It is usually provided in an oral form that is taken once a day for a year or more. Sometimes these drugs are combined with interferon.
Possible side effects associated with antiviral use include: Abdominal or stomach pain (severe)Feeling of fullnessNauseaTingling, burning, numbness, or pain in the hands, arms, feet, or legsFlu-like symptoms, such as fever, body aches, and chills
Common names include: Prednisone
(Prednisone Intensol, Pred-Pak 45)Prednisone and
Some forms of hepatitis are caused by autoimmune reactions, in which the body’s own immune system attacks normal, healthy tissue. Corticosteroids are anti-inflammatory medicines that also suppress immune responses. This helps reduce liver inflammation, which helps prevent cirrhosis from progressing. High doses of prednisone given long-term are associated with an increase in serious side effects. Lower doses of prednisone may be used when combined with azathioprine.
Possible side effects associated with corticosteroid use include: IndigestionGlucose intoleranceBone thinning
Common names include: Penicillamine
Metal chelating agents are drugs that draw toxic metals from the bloodstream so that the body can pass them more effectively in urine or feces. Chelating agents are used to rid the body of excess copper in Wilsons disease or excess iron in hemochromatosis. Both of these rare inherited diseases can produce liver damage resulting in cirrhosis.
Penicillamine and trientine are used to treat Wilsons disease. Deferoxamine is used to treat iron overload associated with hemochromatosis. It is provided as an injection. Chelating agents are very powerful drugs that can have important, serious side effects. Be sure to report these to your healthcare provider.
Possible side effects associated with chelating agents include: FeverJoint painSkin rashBlurred vision or other problems with visionDifficulty breathing, wheezing, or rapid breathingFast heartbeatNausea, vomiting, or diarrhea
Common names include: Phytonadione
Bleeding abnormalities are common in cirrhosis. Vitamin K plays an important role in blood clotting. Because your liver metabolizes this vitamin, liver diseases can affect vitamin K levels and its ability to function. This alters your clotting ability. Your doctor may prescribe vitamin K to help prevent excessive bleeding. The dose of these medicines will be different for different people. Follow your doctor's orders. Do not change your dose unless your doctor tells you.
Possible side effects associated with vitamin K include: Flushing of the faceRedness, pain, or swelling at the site of injectionUnusual taste
Loop diuretics: Bumetanide
Thiazide diuretics: Hydrochlorothiazide
Potassium-sparing diuretics: Amiloride
Diuretics are used to treat the buildup of excess fluid in the body that occurs with cirrhosis and other diseases. These drugs act on the kidneys to increase urine output. This reduces the amount of fluid in the bloodstream. This can help reduce portal vein hypertension and help alleviate some of the symptoms of cirrhosis, such as fluid accumulation in the abdomen and legs.
Possible side effects associated with diuretic use include: Loss of appetiteNausea and vomitingDizzinessHeadacheLack of energyLow or high blood potassium levelLow sodium level
Common names include: Octreotide
(Sandostatin, Sandostatin LAR)
Cirrhosis can lead to bleeding from the esophageal vessels. You may have to take medicine to reduce the pressure in the vessels.
Possible side effects associated with the use of this drug include: Abdominal crampsNauseaVomitingDiarrheaSlow heart rateGreasy stoolsUpset stomach
Common names include: Atenolol
In cirrhosis, these are used to reduce venous blood pressure in the abdomen (called portal hypertension). This reduces the risk of esophageal variceal bleeding and other complications. These drugs come in capsule, tablet, liquid, and injectable forms.
Possible side effects associated with beta-blocker use include: Drowsiness and dizzinessCold sensitivitySleep disorders
Common names include: Beta-galactosidofructose (Lactulose)Senna (laxative)
Laxatives are usually prescribed to treat constipation. However, they can help treat cirrhosis by absorbing or binding toxins, such as ammonia, in the intestine and removing them from the body. Not all laxatives are equally effective. Your doctor may be more likely to prescribe beta-galactosidofructose (Lactulose).
Possible side effects associated with laxative use include: DiarrheaAbdominal cramping, flatulence, and bloatingDehydration and weakness
Common brand names include: CentrumOne-a-Day
Your doctor may recommend that you take a multivitamin and mineral supplement. This will help correct any nutrient deficiencies you may have developed if your dietary intake was reduced because of liver disease.
If you were consuming alcohol regularly, you may need additional thiamine and folate (two B vitamins) as well. Ask your healthcare provider or a registered dietitian for guidance in choosing an appropriate supplement.
If you are taking medications, follow these general guidelines: Take your medications as directed. Do not change the amount or the schedule.Know what side effects could occur. Discuss them with your doctor.Talk to your doctor before you stop taking the medication.Plan ahead for refills if you need them.Do not share your medication with anyone.Drugs can be dangerous when mixed. Talk to your doctor if you are taking more than one drug, including over-the-counter products and supplements.
Cales P, Masliah C, Bernard B, et al. Early Administration of Vapreotide for variceal Bleeding in Patients with Cirrhosis.
New E J Med
Heidelbaugh JJ, Sherbondy M. Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment.
Am Fam Phys
Last reviewed June 2013 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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