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Managing pain and temperatures with a liver problem

What medicine should you give your child if they have a raised temperature?

Paracetamol (also known as Calpol) is the preferred medicine to use in children with a liver problem who has a raised temperature. It can be given at the normal dose for a child of their age. This will be written on the bottle.

What medicine should you give your child if they need pain relief?

Paracetamol is the first medicine you should give your child if they need pain relief. This should be given in normal dosage. The dose will be written on the bottle.

If your child has been diagnosed with a liver problem it is important to make sure that they are given the correct medicine to manage pain or a temperature. Some medicines that are routinely given to children may cause side effects in children who have a liver condition.

Remember:

Medical advice should be sought if there are concerns about the child or if prolonged usage (more than 3 days) is required.

Which medicines should you not give your child with a temperature or for pain relief if they have a liver problem?

Non-steroidal anti-inflammatory drugs (NSAIDS) should not routinely be used in children with liver problems.

How do you know if a medicine is a NSAIDS?

NSAIDS make up a group of medicines with the commonest being ibuprofen (also known as Brufen, Calprofen, Feverfen, Nurofen, Orbifen). Other drugs in this group include the following:

  • Diclofenac
  • Nabumetone
  • Fenoprofen
  • Naproxen
  • Indometacin
  • Piroxicam
  • Mefenamic Acid
  • Aspirin
  • Meloxicam

If in doubt always ask your doctor, nurse or pharmacist.

Why should you not give NSAIDS to people with liver disease?

These medicines can increase the risk of bleeding in people with liver disease and also of increasing fluid retention in more advanced liver conditions.

Aspirin and other aspirin containing products are not usually used in any children. Again due to the increased risk of bleeding with liver disease, aspirin should not be used in children with liver problems.

Is there any occasion when NSAIDS or aspirin should be given to a child with liver disease?

Very occasionally the benefits of using a NSAID or aspirin will outweigh the risk of side effects. This should be discussed with a liver doctor before deciding to give a child this treatment.

Are there any other medicines that can be given for pain?

Opioids such as codeine, dihydrocodeine, morphine, pethidine and tramadol should be used with caution in children with liver disease and should be avoided in those children with significant liver disease. This risks developing encephalopathy (increased sleepiness and confusion).

These should only be given if a doctor has said it is ok to do so.

If you have any questions which medicines to use then discuss these with your pharmacist, doctor or nurse looking after your child.

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Disclaimer

Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

Resource number: HP6

Resource Type: Article

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