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Author Topic: Pain Medications With Hep C  (Read 8885 times)

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Offline Hep Editors

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  • Posts: 784
    • Hep Mag
Pain Medications With Hep C
« on: June 15, 2015, 03:07:58 pm »
People with hepatitis C who are in pain are confronted with the issue of finding pain relief that doesn’t further damage the liver. Fortunately, there is a wide selection of medications and pain management tools.

NSAIDS: Acetaminophen, Tylenol, etc. Considered to be one of the safest drugs there is, even if you have liver disease. It is harmless at low doses.

Aspirin: At high doses, aspirin can injure the liver. However, this damage is not from toxicity, such as what may occur with high doses of acetaminophen. The biggest risk with aspirin is a gastrointestinal (GI) bleed.

Opioids: On their own, opioids rarely injury the liver. However, opioids are sometimes formulated with acetaminophen, and excessive amounts can injure the liver.

For way more information on the subject, click here: http://www.hepmag.com/articles/hepatitis_and_pain_2502_27373.shtml




Offline dragonslayer

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  • Posts: 873
Re: Pain Medications With Hep C
« Reply #1 on: June 15, 2015, 03:57:57 pm »
I never knew Tylenol was considered an NSAID!  Especially since its not an anti-inflammatory. What can I say.. every time I come to this section, I learn  something new!
« Last Edit: June 15, 2015, 09:42:08 pm by dragonslayer »
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline lporterrn

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  • Posts: 1,969
  • LucindaPorterRN
    • LucindaPorterRN
Re: Pain Medications With Hep C
« Reply #2 on: June 15, 2015, 09:01:05 pm »
Well, Paul, personally, although I wrote this article, I am not 100% convinced it is an NSAID. The source I used (http://livertox.nlm.nih.gov/Acetaminophen.htm) says, "While technically a nonsteroidal antiinflammatory drug (NSAID), acetaminophen unlike typical NSAIDs (ibuprofen, naproxen, indomethacin) has only minor effects on tissue cyclooxygenase activity (Cox-1 and Cox-2) and appears to produce analgesia by increasing pain thresholds, perhaps through inhibition of the nitric oxide pathway which is activated by many pain neurotransmitter receptors.  Acetaminophen has lower antiinflammatory activity than aspirin or typical NSAIDs."

However, after that piece went to print, I did some more scratching around and most places categorize it as a plain old analgesic and not an NSAID. So, I am throwing up my hands on this one, and stating that I don't think I can defend my words on this one. The bottom line is I am not convinced it is an NSAID...
Lucinda Porter, RN
1988 Contracted HCV
1997 Interferon nonresponder
2003 PEG + ribavirin responder-relapser
2013 Cured (Harvoni + ribavirin clinical trial)
https://www.hepmag.com/blogger/lucindakporter

Offline dragonslayer

  • Member
  • Posts: 873
Re: Pain Medications With Hep C
« Reply #3 on: June 15, 2015, 09:43:49 pm »
Interesting.. Thanks, Lucinda.
Paul

DX 2008
Started Harvoni 11/26/14 for 8 wks
Completed 8 wks Harvoni 01/20/15
EOT RNA Quant result:  Detected 29
7.5 wk post tx: Detected < LLOQ(12)
11 wk post tx: UNDETECTED SVR12
24 wk post tx: UNDETECTED SVR24; AST 26; ALT 22; ALP 73
48 wk post tx: UNDETECTED SVR48; AST 18; ALT 18; ALP 70
GT 1a
vl 2.4mil
2008 bpx: Stage&Grade 0
2013 bpx: Stage&Grade: 0-1
IL28B: TT
likely infected early '70s

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,543
  • Get tested, get treated, get cured, fight Hep c!
Re: Pain Medications With Hep C
« Reply #4 on: June 15, 2015, 10:51:00 pm »
Interesting I have known since I was diagnosed with cirrhosis that Tylenol is the recommended OTC pain med for people with liver disease as long as taken properly.

I was very surprised to hear that after all the news about Tylenol and the liver but that is only when people take too much which is easy to do since Tylenol is formulated into so many multi-symptom medicines.

And that meds like Advil and Aleve can be dangerous much like aspirin because the can contribute to a GI bleed.

Thanks for the info :)
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Downnout

  • Member
  • Posts: 21
Re: Pain Medications With Hep C
« Reply #5 on: July 03, 2015, 09:48:34 pm »
Well, Paul, personally, although I wrote this article, I am not 100% convinced it is an NSAID. The source I used (http://livertox.nlm.nih.gov/Acetaminophen.htm) says, "While technically a nonsteroidal antiinflammatory drug (NSAID), acetaminophen unlike typical NSAIDs (ibuprofen, naproxen, indomethacin) has only minor effects on tissue cyclooxygenase activity (Cox-1 and Cox-2) and appears to produce analgesia by increasing pain thresholds, perhaps through inhibition of the nitric oxide pathway which is activated by many pain neurotransmitter receptors.  Acetaminophen has lower antiinflammatory activity than aspirin or typical NSAIDs."

However, after that piece went to print, I did some more scratching around and most places categorize it as a plain old analgesic and not an NSAID. So, I am throwing up my hands on this one, and stating that I don't think I can defend my words on this one. The bottom line is I am not convinced it is an NSAID...

When I was first diagnosed with cirrhosis.... (2004) I was specifically told not to take any meds such as Tylenol which has acetaminophen or any other with acetamins... Course I could be wrong.... At that time I had so much ammonia in my body I couldn't remember anything short time. Still have problems because of all the stress, meds etc. I was told the ammonia sucks the oxygen out of your blood and hurts your short time memory.

It can get so highyou might wake up in the middle of the night and take a walk-about..LOL! Thanks to the Law..... They brought me back home... I was hallucinating when he found me fully dressed and walking down the road. Guess the "Lord" was looking out for me... I didn't get hit by a car...... ;D

 


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