By James Bredfeldt, MD **
Drugs can be our friends, but also they can be your liver’s enemy. You may be ingesting some medications that might harm your liver and be unaware of that potential. So, let’s discuss two of these possibilities:
Acetaminophen and the Liver
Acetaminophen is a commonly used medication for pain control and fever reduction. Acetaminophen is found in over-the-counter (OTC), nonprescription medications either in single tablets or in combination with other medications, usually “cold” remedies. It is also used in prescription medications, in combination with narcotic pain medications; for example, hydrocodone-acetaminophen (Vicodin) or oxycodone-acetaminophen (Percocet).
Acetaminophen has the potential to cause serious and fatal liver damage in certain circumstances. When the total daily dose is under 3,000 mg, the potential for liver damage is quite low. When the daily dose begins exceeding 4,000 mg, the potential for liver damage exists, especially when used in those amounts over consecutive days.
Caution should be shown when taking acetaminophen while consuming alcoholic drinks at the same time. Less than three alcoholic drinks a day, preferable none, should be consumed while using acetaminophen, even less than 3,000 mg a day. One alcoholic drink equals 4 ounces of wine, 1 ounce of spirits (such as whiskey, vodka and gin), or 12 ounce bottle of beer.
The important things to remember about acetaminophen are:
- Read the labels on OTC medications that contain it
- Consult with your pharmacist about prescription narcotics that may contain it
- Limit daily acetaminophen amounts to 3,000 mg
- Avoid alcohol consumption while using this drug
Herbal Agents and the Liver
Many individuals use OTC “natural,” or herbal, agents. I often hear the comment that patients don’t want to use prescription medications as they contain “chemicals.” Herbal agents are nothing more than “chemicals” that are produced by plants, rather than by chemists!
Because it is “natural” does not mean that liver damage can’t happen. Here is a list of some herbal agents that are known to cause serious liver damage: black cohosh, comfrey, ginseng, greater celandine, Jin Bu Huan, Kombucha tea, misteltoe, Sho-saiko-to, pennyroyal oil (squawmint oil), sassafras, senna, and skullcap and valerian combined.
One challenge often faced is many of these agents may be listed under an alternative name, often its botanical name, which then becomes quite complicated for identification. So, it is important to ask questions, and even a web search might be beneficial and liver saving.
Love your liver!
When not practicing gastroenterology and hepatology, Dr. Bredfeldt enjoys supporting his alma mater, the University of Kansas.