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Medical Painkillers (analgesics) and the liver

  1. Jun 27, 2008 #1


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    I was thinking about painkillers recently after recovering from some major dentistry. In particular, I was wondering if there were any painkillers that do not stress the liver. I imagine the answer is no, as just about any foreign substance will be broken down there -- but I thought it was worth asking about.

    Aspirin (acetylsalicylic acid), ibuprofen, naproxin, and especially acetaminophen (paracetamol) are hard on the liver, as I understand. I'm not sure, but I imagine Vicodin is as well -- or rather, the small amount of hydrocodone in it is; the acetaminophen certainly is. (My dentist prescribed it for the pain, though this time I didn't feel the need to fill the prescription. I kind of wish I did, in retrospect; the first night the pain didn't let me sleep.)

    And while I'm thinking of it, what can be combined? Clearly aspirin and acetaminophen can be combined, as they're often sold together; clearly Tylenol can't be taken with Vicodin since that's an acetaminophen overdose. I'd guess that Vicodin could be combined with aspirin or another NSAID, but that two NSAIDs should not be used together -- no Aleve with aspirin -- but I don't know.
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  3. Jun 28, 2008 #2


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    Aleve (Naproxen) should not be taken with salicilates, e.g. aspirin.


    See also - http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a681029.html

    Usually with surgery, the pain medication should not involve blood thinning or anti-coagulation, or rather it needs to be balanced with any other anti-clotting agent if that is related to one's condition.

    Certainly check with one's doctor.


    The key with "aspirin (acetylsalicylic acid), ibuprofen, naproxin, and especially acetaminophen (paracetamol)" is the dosage. Low dosage is not a problem, but if one has a liver condition, one should consult with one's doctor regarding use of these analgesics.

    See also http://en.wikipedia.org/wiki/Non-steroidal_anti-inflammatory_drug

    http://www.fda.gov/cder/drug/infopage/COX2/NSAIDmedguide.htm [Broken]
    Last edited by a moderator: May 3, 2017
  4. Jun 29, 2008 #3


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    For clarification:

    I have no liver condition, I'm just generally trying to keep my organs in good shape.

    I'm talking about OTC dosages: 500 to 650 mg of aspirin, 500 mg of acetaminophen, 5 (?) mg of hydrocodone in Vicodin, etc. If I thought I could combine, say, ibuprofen/naproxin/acetaminophen at normal (or half) doses, I might be able to avoid taking Vicodin.

    Also, I'm interested in more explanation for the "long time" warnings that I read about on web pages from the FDA and the like. A friend of mine was on painkillers for almost a year (on a doctor's advice); certainly that's a long time. But failing that, what's a long time? I've been taking over-the-counter pain medicine* for three weeks now for dental pain: two weeks before seeing the dentist and one week after. Should I take special precautions? I suspect I'll be done fairly soon now, but it's good to know for future reference.

    * First half-doses of aspirin (325 mg), then full doses (650 mg), then aspirin + acetaminophen (500 mg each) as the pain increased.
    Last edited: Jun 29, 2008
  5. Jul 7, 2008 #4
    pharmacists exist to answer questions like this.
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