Drugs to be avoided or used with caution in liver disease
Active Ingredient
Comments
Progesterone see Progestogens
Progestogens
Avoid; see also Contraceptive, Oral
Promazine see Antipsychotics
Promethazine see Antihistamines
Propranolol
Reduce oral dose
Protriptyline see Antidepressants,Tricylic
Quinapril see ACE Inhibitors
4-Quinolones
Hepatitis with necrosis re-ported with ciprofloxacin; hepatitis also reported for norfloxacin; nalidixic acid partially conju-gated in liver; reduce dose of ofloxacin in severe liver disease
Ramipril see ACE Inhibitors
Ranitidine
Increased risk of confusion; reduce dose
Rifampicin
Impaired elimi-nation; may be increased risk of hepatotoxicity; avoid or do not exceed 8mg/kg daily
Sertraline see Antidepressants,
SSRI
Simvastatin
Avoid in active liver disease or unexplained persistent elevations in serum transaminases
Sodium Bicarbonate see Antacids
Sodium Fusidate see Fusidic Acid
Sodium Nitroprusside see Nitroprusside
Sodium Valproate see Valproate
Sulphonylureas
Increased risk of hypoglycaemia in severe liver disease; avoid or use small dose; can pro-duce jaundice
Suxamethonium
Prolonged apnoea may occur in severe liver disease due to reduced hepatic synthesis of pseudo-cholinesterase
