Drugs to be avoided or used with caution in liver disease
Active Ingredient
Comments
Haloperidol see Antipsychotics
Heparin
Reduce dose in severe disease
Hydrochlorothiazide see Thiazides
Hydroxyprogesterone Hexanoate
see Progestogens
Hydroxyzine see Antihistamines
Hypnotics see Anxiolytics and Hypnotics
Ibuprofen see NSAIDs
Imipramine see Antidepressants Tricylic
Indapamide see Thiazides
Indomethacin see NSAIDs
Isoniazid
Avoid if possible idiosyncratic hepatoxicity more common
Isotretinoin
Avoid - further impairment of liver function may occur
Isradipine
Reduce dose
Itraconazole
Avoid - toxicity with related drugs
Ketoconazole
Induces hepatitis- like reaction; may accumulate in severe liver disease; contra-indicated unless no alternative
Ketoprofen see NSAIDs
Ketotifen see Antihistamines
Lignocaine
Avoid (or reduce dose) in severe liver disease
Labetalol
Avoid
Loop Diuretics
Hypokalaemia may precipitate coma; potas-sium-sparing diuretic should be used to prevent this in-creased risk of hypomagnesae-mia in alcoholic cirrhosis