One or more medicines may be used for cirrhosis. They may be used to control the cause and prevent more damage. They may also be used to treat symptoms and related health problems.
Here are the basics about each of the medicines below. Only common problems with them are listed.
Prescription Medicines
- Disulfiram
- Naltrexone
- Acamprosate
- Interferons
- Protease inhibitors
- Reverse transcriptase inhibitors
- Prednisone
- Prednisone and Azathioprine
- Penicillamine
- Trientine
- Deferoxamine
- Ciprofloxacin
- Norofloxacin
- Ceftriaxone
- Rifaximin
- Ofloxacin
- Amoxicillin-clavulanate
- Phytonadione
- Fresh frozen plasma
- Platelet transfusion
- Blood clotting factors
- Desmopressin (DDAVP)
- Bumetanide
- Furosemide
- Hydrochlorothiazide
- Chlorothiazide
- Amiloride
- Triamterene
- Spironolactone
- Octreotide
- Atenolol
- Metoprolol
- Nadolol
- Propranolol
- Timolol
- Carvedilol
- Beta-galactosidofructose
Over-the-Counter Medicines
Prescription Medicines
Common names are:
- Disulfiram
- Naltrexone
- Acamprosate
These medicines treat alcohol use disorder. A person who drinks while taking disulfiram will have hangover symptoms that are much worse than normal. Problems may be headache, nausea, confusion, and uneasiness. Naltrexone lowers the craving for alcohol. Acamprosate lowers both the physical and emotional unrest that happens from quitting drinking, such as sweating, sleep problems, and unease.
Some problems may be:
- Drowsiness
- Erectile dysfunction
- Headache
- Mood changes
- Peripheral neuropathy
- Psychosis
- Belly cramps
- Skin problems, such as rash and itching
- Problems sleeping
- Muscle pain
- Vomiting
- Diarrhea
Common ones are:
- Interferons
- Protease inhibitors
- Reverse transcriptase inhibitors
Chronic viral hepatitis B and C may get better with antiviral medicines. These may be interferon for hepatitis B and C. Taking both interferon and ribavirin may be more helpful for hepatitis C than taking one alone.
Lamivudine, tenofivir, adefovir, entecavir, and telbivudine are used to treat hepatitis B infection. They are often taken by mouth once a day for a year or more. Sometimes these drugs are taken with interferon.
Some problems may be:
- Belly pain
- A feeling of fullness
- Nausea
- Peripheral neuropathy
- Flu-like symptoms, such as fever, body aches, and chills
Common names are:
- Prednisone
- Prednisone and azathioprine
Some forms of hepatitis are caused by the body's immune system attacking normal, healthy tissue. Corticosteroids can help suppress the attack. This helps ease liver inflammation, which helps prevent cirrhosis from getting worse. High doses of prednisone taken for a long time may cause serious side effects. Lower doses of prednisone may be used when taken with azathioprine.
Some problems may be:
- Stomach upset
- Glucose intolerance
- Bone thinning
- A higher risk of infection
- Changes in behavior
Common names are:
- Penicillamine
- Trientine
- Deferoxamine
Chelating agents are drugs that draw toxic metals from the blood. This lets them pass more easily in urine or stool. Chelating agents are used to rid the body of excess copper in a person with Wilson disease or excess iron in a person with hemochromatosis. These are rare inherited problems can cause liver damage that leads to cirrhosis.
Penicillamine and trientine are used to treat Wilson disease. Deferoxamine is used to treat iron overload from hemochromatosis. It is given as an injection. Chelating agents are strong medicines that can cause serious side effects.
Some problems may be:
- Fever
- Joint pain
- Skin rash
- Blurry eyesight or other sight problems
- Problems breathing
- Fast heartbeat
- Nausea and vomiting
- Diarrhea
Common names are:
- Ciprofloxacin
- Norofloxacin
- Ceftriaxone
- Rifaximin
- Ofloxacin
- Amoxicillin-clavulanate
Antibiotics may be used to prevent bacterial infection in people who have cirrhosis and gastrointestinal bleeding.
Some problems may be:
- Nausea or vomiting
- Diarrhea
- Belly pain
- Headache
- Rash or hives
Common names are:
- Phytonadione
Bleeding problems are common in cirrhosis. Vitamin K plays helps with blood clotting. Problems with the liver can make it hard to get enough. Vitamin K supplements may need to be taken to help prevent excessive bleeding.
Some problems may be:
- Flushing of the face
- Redness, pain, or swelling at the site a vitamin K injection
- Changes in taste
This process changes blood from a liquid to a thickened gel. This helps the body control blood loss. A blood transfusion may be needed to help people who have a lot of bleeding or bleeding that does not get better with treatment. Blood transfusions use one or more of these:
- Frozen fresh plasma
- Platelets
- Specific clotting factors
Problems are rare, but may be:
- Allergic reaction
- Fever
- Infection
- Iron overload
- Lung injury
- Immune reaction
Desmopressin (DDAVP) is used to help release von Willebrand factor. This is a protein in the blood linked to blood coagulation. It is often given by IV.
Problems may be:
- Headache
- Fluid buildup, which may increase weight
- Flushing of the face
- Nausea
- Seizures
- Low sodium level—hyponatremia
Loop diuretics:
- Bumetanide
- Furosemide
Thiazide diuretics:
- Hydrochlorothiazide
- Chlorothiazide
Potassium-sparing diuretics:
- Amiloride
- Triamterene
Diuretics are used to treat the buildup of fluid in the body from cirrhosis. They act on the kidneys to help the body make more urine. This lowers the amount of fluid in the blood. This can help lower blood pressure in the portal veins. This can ease some of the problems from cirrhosis, such as swelling in the belly and legs.
Problems may be:
- Lack of hunger
- Nausea and vomiting
- Lightheadedness
- Headache
- Lack of energy
- Low or high blood potassium level
- Low sodium level
Common names are:
- Octreotide
Cirrhosis causes higher pressure in the liver. This can cause blood to back up and cause swelling in the blood vessels in the esophagus and digestive tract. This can cause serious bleeding. Medicines can help ease pressure and lower the risk of bleeding.
Some problems may be:
- Belly cramps
- Nausea and vomiting
- Diarrhea
- Slow heart rate
- Greasy stools
- Upset stomach
Common names are:
- Atenolol
- Metoprolol
- Nadolol
- Propranolol
- Timolol
- Carvedilol
Cirrhosis can raise blood pressure in the belly. This can cause blood to back up and cause swelling in the blood vessels in the esophagus and digestive tract. This can cause serious bleeding. Medicines can help ease pressure and lower the risk of bleeding. These may be given by mouth or by injection.
Some problems may be:
- Drowsiness and lightheadedness
- Cold sensitivity
- Problems sleeping
Common names are:
- Beta-galactosidofructose (Lactulose)
- Senna
- Polyethylene glycol
Laxatives are usually taken to treat constipation. They can also help treat cirrhosis by helping to remove toxins from the body.
Some problems may be:
- Diarrhea
- Belly cramping, gas, and bloating
- Dehydration and weakness
Over the Counter Medicines
A multivitamin and mineral supplement can be taken to replace nutrients that are lowered because of liver disease. In a person with alcohol use disorder, thiamine and folate (two B vitamins) may also be needed.
References
Cirrhosis. American Liver Foundation website. Available at: http://www.liverfoundation.org/abouttheliver/info/cirrhosis. Accessed January 6, 2021.
Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis. Accessed January 6, 2021.
Cirrhosis of the liver. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cirrhosis-of-the-liver-31. Accessed January 6, 2021.
Ge PS, Runyon BA. Treatment of Patients with Cirrhosis. N Engl J Med. 2016 Aug 25;375(8):767-777.
Revision Information
- Reviewer: EBSCO Medical Review Board Daniel A. Ostrovsky, MD
- Review Date: 12/2020
- Update Date: 01/06/2021