Cirrhosis: Common medication for the management of liver disease

Introduction

This information leaflet has been given to you because you are starting or have already started taking medication to help manage your liver. This leaflet gives information on the common medication used in the management of liver disease.

Long term inflammation can cause scarring and liver damage. Scarring of the liver is also known as cirrhosis. The aim of treatment is to stop the cirrhosis getting any worse and to treat any disabling or life threatening complications.

For the management of cirrhosis, there can be different medication prescribed depending on your condition. This leaflet highlights the most common medication that can be used. You may be prescribed one or more of the medicines discussed in this leaflet.

Hepatic encephalopathy

When the liver is working well, it can help get rid of waste products from your body. In liver disease, the body cannot get rid of the waste products effectively and they can be carried to the brain by your blood. This can cause confusion or short term memory problems.

Other symptoms may include feeling tired, tremors or having difficulty carrying out simple tasks.

Lactulose – is a sweet syrup-like medicine. It is a laxative which helps the body to remove toxins that can build up when the liver is failing. It also helps to prevent the growth of bacteria that produce ammonia in the bowel, which can affect brain function. It is important to have at least 2 to 3 bowel movements per day.

Rifaximin - helps to prevent infections and remove toxins from building up in the body when the liver is failing.

Ascites and peripheral oedema

Ascites (fluid building up in the tummy) and swelling in the ankles or legs (peripheral oedema) can be a common complication of cirrhosis. Ascites can be uncomfortable and may cause difficulty breathing.

Spironolactone and Furosemide are also known as diuretics. These medicines help the body get rid of excess fluid.

Antibiotics such as co-trimoxazole – fluid building up in the tummy (ascites) can become infected; antibiotics can be used to help treat the infection or may be used in lower doses to prevent infection.

Portal hypertension and variceal bleeding

Propranolol and carvedilol – known as beta blockers, reduce the risk of bleeding by helping to lower the high blood pressure in the main vein that takes blood to the liver (portal hypertension) and can help to reduce the risk or severity of bleeding.

Steroids

Prednisolone – steroids can help to reduce inflammation in the liver. Steroids are usually prescribed as a reducing course. It is best to take this medication with/after food.

Calcium and vitamin D supplementation – such as Adcal D3, can be prescribed for bone protection whilst taking a course of steroids. The calcium and vitamin D supplement may be stopped once the course of steroids has been completed.

Multivitamins

Thiamine – vitamin B supplement helps prevent toxins building up in the body due to the liver failing and supplement for vitamin B deficiency.

Sanatogen A-Z or Forceval – multivitamins which help to provide support for vitamin deficiency.

Side effects

All medication can be associated with side effects. For more detailed information, refer to the leaflet provided by the manufacturer in the medicine package.

Top tips for taking medication

  • If you miss a dose, take the next one as soon as you remember, but do not take a double dose unless you are told to do so. If there is a problem or you forget more than one dose, ask your doctor or pharmacist for advice. Make sure you have enough supplies of your medicines, particularly over bank holidays or if you plan to travel away from home. Order repeat prescriptions well in advance in case the pharmacy runs out of stock.
  • It is important that you take all your regular medication at the right time.
  • If starting any new medication (including over the counter medication), always check with your community pharmacist or GP if is it safe with liver disease.

How will I get further prescriptions?

Your GP will prescribe your repeat prescriptions. You will be able to take your prescription to your local pharmacist to get more supplies, or the local pharmacy may receive your prescription directly from your GP surgery.

For more detailed information on medication, information is provided by the manufacturer in the medicine package. This leaflet has been designed to inform you what each medication is used for and why it is important.

If you have any further questions or concerns, please speak to your doctor or pharmacist.

Resources

http://www.britishlivertrust.org.uk/wp-content/uploads/Lo-res-CIL0411.pdf

https://www.nhs.uk/conditions/cirrhosis/treatment/

How to contact us:

Appointments helpline: 0300 555 0103

LiverNurses@nbt.nhs.uk

Medicines.Information@nbt.nhs.uk

If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.

© North Bristol NHS Trust. This edition published April 2021. Review due April 2023. NBT003334

Cirrhosis: Common medication for the management of liver disease