Fatty liver disease is a condition in which fat deposits build up within the liver tissue. Fatty liver disease can occur as a result of chronic alcoholism or can be classified as nonalcoholic fatty liver disease. Fatty liver disease is normally harmless and without symptoms, but in more severe cases it can progress to steatohepatitis, which is a type of inflammation of the liver, cirrhosis of the liver or liver failure. Since your liver processes many of the medications you take, you should choose over-the-counter pain medications carefully if you have any type of liver disease.
Doctors are often unable to determine the exact cause of fatty liver disease, but certain behaviors and medical conditions are risk factors for developing the disorder. Alcohol abuse, gastric bypass surgery and rapid weight loss are associated with fatty liver. Medical conditions such as obesity, metabolic syndrome, high cholesterol and Wilson's disease are risk factors. According to "U.S. News & World Report," losing weight, adopting a healthy diet, getting regular exercise and controlling your blood sugar if you are diabetic can help treat nonalcoholic fatty liver disease. Since certain medications can lead to fatty liver disease or cause it to get worse, you should talk to your physician about which medications you should avoid if you have fatty liver disease.
Acetaminophen, or APAP, is the painkiller and fever reducer that is the active ingredient in Tylenol. Many over-the-counter cold remedies and prescription painkillers also contain APAP. Acetaminophen overdose is well known for causing liver toxicity and even acute liver failure. This is because your liver breaks APAP down into a chemical that is poisonous to liver cells, but an antioxidant in your body called glutathione prevents the toxin from harming your liver. Excessive doses of APAP override the glutathione and leave your liver vulnerable to damage, but smaller doses are safe. According to Dr. Melissa Palmer, M.D., small doses such as one to two 500-mg tablet of APAP per 24 hours can be safer for people with liver disease than some other drugs, such as aspirin.
Nonsteroidal Anti-Inflammatory Drugs
Nonsteroidal anti-inflammatory drugs, or NSAIDs, are a class of medications that reduce inflammation without some of the undesirable side effects of steroids. NSAIDs also reduce fever and relieve pain. NSAIDs include drugs such as ibuprofen, aspirin and naproxen. While the exact mechanism is unknown, NSAIDs all have the potential to be toxic to your liver. According to Dr. James Wolfe, M.D., aspirin, also called ASA or acetylsalicylic acid, is well documented for causing liver damage when taken in high therapeutic doses and even occasionally at lower doses. This is why Dr. Melissa Palmer, M.D. recommends that people with liver disease avoid all NSAIDs unless they are medically necessary for treatment of another condition. Even in those cases, Dr. Palmer recommends much smaller NSAID doses over a limited time for people with liver disease.
Because your liver is one of your body's most complex vital organs, you should ask your doctor before you take any over-the-counter medication, vitamin or supplement if you have liver disease. Even some normally harmless herbs can have adverse effects on liver disease. You should see your doctor regularly to monitor your liver function. Be sure to read the label of any over-the-counter medicines before you take them, since many contain acetaminophen or NSAIDs and you could accidentally take a medicine your doctor advises against, or take too much of a drug by combining medications that contain the same active ingredients.
- MayoClinic.com: Nonalcoholic Fatty Liver Disease
- Drug Metabolism and Disposition; Acetaminophen-Induced Hepatotoxicity; Laura P. James, Laura P., Philip R. Mayeux and Jack A. Hinson; Dec. 2003
- MedLinePlus.com; Acetaminophen
- Palmer, Melissa, M.D.; Alcohol and Liver Disease/Hepatitis
- Palmer, Melissa, M.D.; Painkillers and Liver Disease/Hepatitis
- Annals of Internal Medicine; Aspirin Hepatitis; Wolfe, James D., M.D., Allan L. Metzger, M.D. and Robert C. Goldstein, M.D.; Jan. 1974
- U.S. News & World Report; Nonalcoholic Fatty Liver Disease: 5 Tips for Treatment, Prevention; Payne, January W.; April 2009