I’ve been so mad. For weeks now I’ve been experiencing pain in my leg. Tried walking on it. Resting it. But not getting any better so managed to obtain a GP appointment. She advised me to use Ibuprofen Gel, when I’d already informed her that I have cirrhosis. I replied and said that I’m not allowed to use it. She then said, well you’ll only need to use a bit!!! I said under no circumstances should anyone like me use any form of Ibuprofen. I’ve double checked with Hepatology at the hospital and they’ve agreed with me.
As I understand it, Ibuprofen can cause internal bleeding and as someone with platelets at only 41, it’s a worry.
Why is everything so difficult!!!
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Oscar21
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Hi. I have cihrossis too and no-one ever told me not to use ibuprofen gel. I'm on duloxetine for pain which is bad for the liver so is co-codamol as it contains paracetamol. I do take co-codamol from time to time and I'm permanently on duloxetine for pain (osteo-arthritis etc. I'm glad I saw your post. Hope your leg gets better soon. Best wishes Golly
My advice is to Always check with Hepatology before taking any meds. Do not rely on your GP. Certain medications are a big no no for people like us and Ibuprofen is one of them.
We are allowed paracetamol but I don’t know anything about dulexotine.
Hiya. I was told not to take paracetamol because of my liver unless absolutely necessary. I find I get a variety of different opinions on things. I almost feel like they want me to shut up! Thanks for replying and take care. Best wishes Jo
Paracetamol is usually considered safe up to 2g/24hr. Codeine is more iffy, as it requires your liver to process it into morphine, which it may not do very well/at all
That sounds incredibly frustrating, and you’re absolutely right to question the advice you were given. Unfortunately, many general practitioners are not fully aware of the risks that certain medications pose for patients with cirrhosis.
Ibuprofen and other NSAIDs (like diclofenac) can be dangerous because they increase the risk of gastrointestinal bleeding, especially in people with low platelets and portal hypertension. They can also reduce kidney function, which is already a concern in cirrhosis. Even topical NSAIDs, while lower risk than oral ones, still absorb into the bloodstream to some extent.
It’s disappointing that you had to be the one to correct your GP instead of receiving well-informed advice from the start. I completely understand your frustration—managing cirrhosis or other chronic liver diseases is already challenging without having to second-guess medical recommendations.
For pain relief, have you been offered safer alternatives? Lidocaine patches, for example, could be a good option for localized pain, and paracetamol (acetaminophen) in low doses (1.5-2g/day) is generally considered safe for cirrhosis. If the pain is persistent, maybe your hepatology team could help with a better management plan?
You’re doing the right thing by advocating for yourself. It’s just unfortunate that it has to be this way!
I agree it’s so frustrating. I rarely go to the GPs because I find they know little in relation to liver disease. But they can’t know everything about every health problem I suppose. But it infuriated me on this occasion. And I’m going to type a letter of complaint.
This is why I always check with Hepatology. They say the GP is responsible for a patients care.
I’m managing ok with a few paracetamol. And I’ll see how I go.
Thank you for your response. You’re absolutely right to double-check with hepatology.
While GPs can’t be specialists in everything, they are expected to have a basic understanding of managing patients with chronic conditions, including liver disease. Unfortunately, not all of them are equally well-informed, which can lead to these frustrating situations. Raising awareness—whether through patient advocacy or formal complaints—might help improve this in the long run.
It’s good that you’re managing with paracetamol for now, and I hope your leg pain improves soon.
Hello,Anything you take is processed by the Liver. We used to think of it in terms of what makes the liver have to work hard when it should be having a rest to heal or stop progression. I don't think Drs will ever say "not allowed" when it comes to drugs but to be safe my husband only ever took anything that was prescribed whilst he had cirrhosis.
He chose not to have paracetamols or any form of painkiller except for once when he had a high fever. But this was his choice to give his Liver the best possible chance.
His cirrhosis was thought to be partly caused by taking nsaids for 10 years(prescribed by GP). One of his consultants said the medication he was on - naproxen - was a swear word at their hospital. It does actively damage the Liver.
I was told once by a GP that he’d prescribe me ibuprofen, when I said I wasn’t supposed to take it he proceeded to say he can prescribe another product that will counter the ibuprofen side effects I may get.
I couldn’t see the point myself so refused.
My hepatology consultant said they could write to my GP surgery and advise them.
Just to add to all the good advice. My consultant said I could take paracetamol when necessary but only half the normal dose. I think it depends on the weight of the patient.
I have Compromised cirrhosis caused by autoimmune hepatitis. My consultant has told me if I need pain relief only to use paracetamol, but only in half doses.
He told me that I couldn’t use Ibuprofen tablets for pain relief. I questioned if this was the same for Ibuprofen gels for muscle pain and he didn’t have a problem with using gels. I am guessing the gel is okay because it’s a different delivery system and has a minimal affect on the liver.
However don’t take this as advice. I would contact your consultant’s secretary and just ask to check with him. My consultant secretary is great and if I have any questions I will usually get a reply the same day either from the secretary or the consultant himself.
I am lucky as I am in the NHS Wales system and since first finding out I had issues with my liver, the treatment and support has been been incredibly. I hope it’s the same wherever you are.
I’ve checked with the Specialist Nurses in Hepatology. They have confirmed via email this week that Ibuprofen in any form ie tablets or gel is not to be used if you have cirrhosis.
I went to the Dr. With shoulder pain that hadn’t resolved after physio. The Dr prescribed Naproxen and Lansoprazol. I mentioned straight away I didn’t think a could have the meds as I had cirrhosis. She said it was fine. On picking up the meds the accompanying leaflet said in bold not to be taken if you have liver disease. Rang the Drs. They said I should not take it and wrote a prescription for anti spasmodic medication. I’d wasted £20 on two meds, but that’s not the point. Even though I’d clearly pointed out that it was not suitable she did the prescription. It was a late 7pm appointment, maybe tired and hungry but sorry I have no faith.
Wow, I didn't know you couldn't use ibrofen gel, I was prescribed it on Monday and I've been using it for the last 5 days. It was helping as well, but A O... pain in neck and shoulder will have to remain..
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