Cirrhosis, HE and lorazepam - British Liver Trust

British Liver Trust

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Cirrhosis, HE and lorazepam

CHanse profile image
28 Replies

hello everyone

Hoping for some guidance from you lovely people. Does anyone know if lorazepam should be given to someone with cirrhosis and hepatic encephalopathy. I’m sure I read somewhere that any benzodiazepines shouldn’t be taken and could bring on an HE episode.

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CHanse
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28 Replies
Fibro2021 profile image
Fibro2021

Hello,Benzodiazepines may exacerbate the symptoms of hepatic encephalopathy, and in some cases even cause hepatic coma.

CHanse profile image
CHanse in reply toFibro2021

thank you Fibro2021, I thought I had read that somewhere

Lvone38 profile image
Lvone38 in reply toFibro2021

Wow, this reply sounds as good as a Dr. Google reply.. Way to go.

Fibro2021 profile image
Fibro2021 in reply toLvone38

Thanks for your reply. I appreciated the irony. My response to the user's question was general. If you allow me, now I would like to be more specific, if I may. The main thing is that the treatment of a particular patient is determined by his doctor, who evaluates all the possible risks and benefits of his decisions. I'm sure the doctor did it. The doctor should inform the patient or caregivers of the possible risks associated with treatment and the symptoms and signs to be aware of during treatment. Probably, this doctor did not do it, otherwise we would not have seen the question of the forum member (It is possible that I am mistaken in making such a conclusion). The treatment for insomnia caused by hepatic encephalopathy lies in the correct treatment of hepatic encephalopathy. As a rule, this is the combined use of lactulose and rifaximin. A constant adjustment of the dose of lactulose is necessary, as well as the restoration of the nutritional status of the patient. The potential danger of prescribing benzodiazepines is not their hepatotoxicity. The hepatotoxicity of benzodiazepines is relatively low. However, the simultaneous action of benzodiazepines and intestinal toxins (they penetrate the blood-brain barrier and act as false neurotransmitters and neuromideators) on the brain can aggravate the symptoms of hepatic encephalopathy.

CHanse profile image
CHanse in reply toFibro2021

thank you for the info. It’s certainly something to think about

pushthrough profile image
pushthrough in reply toFibro2021

you won’t find a better answer than fibro.

Ubwa profile image
Ubwa

Lorazepam is considered “safer” than other benzodiazepines as it doesn’t need to be metabolised by the liver as much as others.

But any drug, if it can be, should be avoided as much as possible with cirrhosis. But sounds like you know that 👍

Depends on your profile though, my hepatologist prescribed it for me to help sleep, nothing bad happened. The sleep was welcomed though.

CHanse profile image
CHanse in reply toUbwa

thanks for the reply. I just was trying to understand if it was the cause of my pal going into a quite bad episode

Lvone38 profile image
Lvone38

Definitely agree with what Ubwa replied. It comes down to quality of life. My Father who had Cirrhosis was prescribed quite the amount of drugs that were not normally considered "Liver Friendly" including Ativan and pain killers but as his doctor stated, it's about the quality of life.

CHanse profile image
CHanse in reply toLvone38

thanks for the reply. It helps to understand why the doctor prescribed them

Chick_atee profile image
Chick_atee

As I understand benzodiazepines are not to be taken if you have cirrhosis and as kettle meds as possible. This will be up to your consultant to decide I would think.

Chick_atee profile image
Chick_atee in reply toChick_atee

typo!…little I meant.

CHanse profile image
CHanse in reply toChick_atee

thanks, it was his GP that has prescribed them

Chick_atee profile image
Chick_atee

No harm to check with your consultant to confirm it’s safe.

Wishing you the best.

CHanse profile image
CHanse in reply toChick_atee

thanks Chic_atee, will do

BritishLiverTrust3 profile image
BritishLiverTrust3AdministratorBritish Liver Trust

Dear CHanse,

This is a question that your own health care professional is best placed to answer, as only they have access to your medical records.

We suggest talking this through with your own doctor or health care professional in the first instance.

If you [are in the UK and] would find it useful to talk things over, our nurse-led helpline is open Monday to Friday from 9am to 3pm on 0800 652 7330 (excluding bank holidays)

Best wishes

British Liver Trust

ferdy74 profile image
ferdy74

I have just been hospitalized with kidney failure I am at home not good but my neighbors daughter is caring for me she's a chef. But getting back to lorazepam I am on that drug in hospital they wanted to take me off it then when they found out ni had been taking it30 year's they said I couldn't because my body could go into a seizure and die hope this helps

CHanse profile image
CHanse in reply toferdy74

hope you get the care you need ferdy74

Millie09 profile image
Millie09 in reply toferdy74

I hope you feel better soon

Babygirl101 profile image
Babygirl101

I was hospitalised with HE and hepatitis two days into a detox and vaguely remember being told that they were using lorazepam rather than Librium as it’s considered easier on the liver. I was really poorly though, so didn’t question anything.

CHanse profile image
CHanse

thanks Babygirl101, hope you are feeling better now

Babygirl101 profile image
Babygirl101

I’m 100% better now, thank you. I’ve been sober since March 22’, so approaching my first birthday. Life is so much better without alcohol.

CHanse profile image
CHanse in reply toBabygirl101

that’s great news, keep up the good work

ferdy74 profile image
ferdy74 in reply toBabygirl101

i been sober for 30 years, that's when they, they put me on that vile drug, it works for a start, good sleep no anxiety brilliant they increase the dose, until i was taking 5 a day, and still am, they don't do me no good in fact I think they make things worse because i am addicted to them, and they will not take responsibility for this, they say well the doctors in those day dissed pills out like smarties, so you keep up the good work and keep clear of these vile things, good luck

Genieus profile image
Genieus in reply toferdy74

Can you reduce by half a tablet per month?

Genieus profile image
Genieus in reply toBabygirl101

You amazing person! Life will get better and better! I'm on my 26th year, sometimes, particularly lately when so much stress happened in a short time, all I wanted was a can of cider. We know this would make everything so much worse.....like a slow death sentence....So I got a cold energy drink, gosh! Cold bubbles were all I wanted! So that's why the 26 years don't matter. The 24 hours really matter! Much love to you.

Babygirl101 profile image
Babygirl101 in reply toGenieus

Thank you! The last few months have been the worst of my life too. I lost my grandma in December and my dad in February. We also had to wait 5 weeks for my dads funeral as it was a sudden death. His funeral was Friday gone, so if anyone can justify picking up, I can, but it won’t bring anyone back to life and will certainly make my life worse. It just isn’t worth it!

pushthrough profile image
pushthrough

every drug that any doctor prescribes should be ran by the liver specialist. I ask my specialist about every single thing including something as simple as my protein powder. That’s just my opinion though.

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