Effect of misoprostol on ibuprofen-induced renal dysfunction in patients with decompensated cirrhosis: results of a double-blind placebo-controlled parallel group study

Ackerman, Zvi; Cominelli, Fabio; Reynolds, Telfer B.

doi:10.1111/j.1572-0241.2002.05847.x

Cited by 26 publications

(13 citation statements)

References 30 publications

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“…The study suggested that the risk of developing this complication in cirrhotic patients using NSAIDs are approximately three times more than cirrhotic patients who do not use these compounds ( 40 ). The renal impairment with reduced glomerular filtration rate (GFR), renal blood flow, and sodium and water excretion has been indicated in cirrhotic patients when different NSAIDs including ibuprofen ( 41 , 42 ), indomethacin ( 43 ) aspirin ( 44 ) naproxen ( 45 ) and sulindac are administered ( 46 ).…”

Section: Resultsmentioning

confidence: 99%

The Therapeutic Use of Analgesics in Patients with Liver Cirrhosis: A Literature Review and Evidence-Based Recommendations

et al. 2014

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Context:Pain management in cirrhotic patients is a major clinical challenge for medical professionals. Unfortunately there are no concrete guidelines available regarding the administration of analgesics in patients with liver cirrhosis. In this review we aimed to summarize the available literature and suggest appropriate evidence-based recommendations regarding to administration of these drugs.Evidence Acquisition:An indexed MEDLINE search was conducted in July 2014, using keywords “analgesics”, “hepatic impairment”, “cirrhosis”, “acetaminophen or paracetamol”, “NSAIDs or nonsteroidal anti-inflammatory drugs”, “opioid” for the period of 2004 to 2014. All randomized clinical trials, case series, case report and meta-analysis studies with the above mentioned contents were included in review process. In addition, unpublished information from the Food and Drug Administration are included as well.Results:Paracetamol is safe in patients with chronic liver disease but a reduced dose of 2-3 g/d is recommended for long-term use. Non-steroidal anti-inﬂammatory drugs (NSAIDs) are best avoided because of risk of renal impairment, hepatorenal syndrome, and gastrointestinal hemorrhage. Most opioids can have deleterious effects in patients with cirrhosis. They have an increased risk of toxicity and hepatic encephalopathy. They should be administrated with lower and less frequent dosing in these patients and be avoided in patients with a history of encephalopathy or addiction to any substance.Conclusions:No evidence-based guidelines exist on the use of analgesics in patients with liver disease and cirrhosis. As a result pain management in these patients generates considerable misconception among health care professionals, leading under-treatment of pain in this population. Providing concrete guidelines toward the administration of these agents will lead to more efficient and safer pain management in this setting.

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Section: Resultsmentioning

confidence: 99%

The Therapeutic Use of Analgesics in Patients with Liver Cirrhosis: A Literature Review and Evidence-Based Recommendations

et al. 2014

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“… 477 Indeed, roughly 10% of total drug-induced hepatotoxicity cases are related to NSAIDs, 478 and NSAID-induced liver injury is well documents. 466 , 479 Moreover, NSAIDs can cause nephrotoxicity, 480 gastric ulcer, hemorrhage, 481 , 482 decompensation of liver function, etc. 472 …”

Section: Drug Treatment For Cancer Pain In Hccmentioning

confidence: 99%

2014 KLCSG-NCC Korea Practice Guideline for the Management of Hepatocellular Carcinoma

2015

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The guideline for the management of hepatocellular carcinoma (HCC) was first developed in 2003 and revised in 2009 by the Korean Liver Cancer Study Group and the National Cancer Center, Korea. Since then, many studies on HCC have been carried out in Korea and other countries. In particular, a substantial body of knowledge has been accumulated on diagnosis, staging, and treatment specific to Asian characteristics, especially Koreans, prompting the proposal of new strategies. Accordingly, the new guideline presented herein was developed on the basis of recent evidence and expert opinions. The primary targets of this guideline are patients with suspicious or newly diagnosed HCC. This guideline provides recommendations for the initial treatment of patients with newly diagnosed HCC.

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“…Indeed, roughly 10% of total drug-induced hepatotoxicity cases are related to NSAIDs ( 478 ), and NSAID-induced liver injury is well documents ( 466 , 479 ). Moreover, NSAIDs can cause nephrotoxicity ( 480 ), gastric ulcer, hemorrhage ( 481 , 482 ), decompensation of liver function, etc. ( 472 ).…”

Section: Drug Treatment For Cancer Pain In Hccmentioning

confidence: 99%

2014 Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guideline for the Management of Hepatocellular Carcinoma

Park¹,

Lee²,

Suh³

et al. 2015

Korean J Radiol

162

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Effect of misoprostol on ibuprofen-induced renal dysfunction in patients with decompensated cirrhosis: results of a double-blind placebo-controlled parallel group study

Abstract: Ibuprofen causes renal dysfunction in decompensated cirrhotics, whereas misoprostol may have some protective renal effects, which are, however, short lived and clinically insignificant. Because of side effects, misoprostol should be used with caution in these patients.

Cited by 26 publications

References 30 publications

The Therapeutic Use of Analgesics in Patients with Liver Cirrhosis: A Literature Review and Evidence-Based Recommendations

The Therapeutic Use of Analgesics in Patients with Liver Cirrhosis: A Literature Review and Evidence-Based Recommendations

2014 KLCSG-NCC Korea Practice Guideline for the Management of Hepatocellular Carcinoma

2014 Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guideline for the Management of Hepatocellular Carcinoma

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