Acetaminophen is the biggest culprit by far, according the review published in AACN Advanced Critical Care, but isn't the only problem drug.
Early Signs of Liver Damage from Medication
Fever. Diarrhea. Dark urine. Jaundice, a condition that occurs when a substance called bilirubin builds up in the blood and causes the skin and whites of the eyes to appear yellow.
Nonprescription pain relievers such as acetaminophen (Tylenol, others), aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, others) can damage your liver, especially if taken frequently or combined with alcohol.
So what does liver pain feel like? It manifests in different ways, but a common form is a dull throbbing. For some people, it occurs as a sharp, stabbing pain. Sometimes the pain migrates to other nearby areas, such as the right shoulder blade and the back.
Nausea. Vomiting. A general sense of feeling unwell (malaise) Disorientation or confusion.
Stage 1: Inflammation
In the early stages of liver disease, the liver will become swollen or inflamed as the body's natural response to injury. Liver inflammation, or hepatitis, can also occur when there are more toxins in the blood than the liver is able to manage. The earlier the diagnosis, the better.
Paracetamol toxicity, albeit accidental or intentional overdose, is an ongoing global problem that continues to result in cases of hepatotoxicity, acute liver failure, and even irreversible liver injury necessitating liver transplantation.
Medications commonly implicated in causing fatty liver include corticosteroids, antidepressant and antipsychotic medications and, most commonly, tamoxifen.
Too much refined sugar and high-fructose corn syrup causes a fatty buildup that can lead to liver disease. Some studies show that sugar can be as damaging to the liver as alcohol, even if you're not overweight. It's one more reason to limit foods with added sugars, such as soda, pastries, and candy.
Studies show that more cases of acute liver failure are caused by prescription and over-the-counter drugs (OTC), herbs, and dietary supplements than all other reasons combined. Some don't show any symptoms, while others cause symptoms to appear.
Pain in your liver itself can feel like a dull throbbing pain or a stabbing sensation in your right upper abdomen just under your ribs. General abdominal pain and discomfort can also be related to swelling from fluid retention and enlargement of your spleen and liver caused by cirrhosis.
Blood tests used to assess the liver are known as liver function tests. But liver function tests can be normal at many stages of liver disease. Blood tests can also detect if you have low levels of certain substances, such as a protein called serum albumin, which is made by the liver.
There are at-home liver panel tests that can determine liver function by screening for proteins and enzymes like albumin, globulin, ALP, ALT, and GGT. These tests use a finger-prick sample and include materials to collect and send your specimen to the lab. You can order a liver panel from home and get tested in a lab.
Paracetamol in high single doses (typically 15 g or more) causes liver injury through a toxic metabolite, NAPQI (N-acetyl-p-benzoquinone imine).
Avoid certain supplements: Excess iron, niacin, and vitamin A (the retinol form, not beta carotene) tend to stress an unhealthy liver. Check your multi and B-complex for these ingredients.
Acetaminophen (a∙SEET∙a∙MIN∙o∙fen) is an active ingredient in many over-the-counter and prescription medicines that help relieve pain and reduce fever.