Precautions for Clinical Medication Use in Patients with Hepatic Insufficiency
Dec 02, 2025
Source: Cainiu Health
Dr. Gao Jun
Introduction
When prescribing medications for patients with hepatic insufficiency, clinicians should follow several precautions to reduce additional hepatic burden: avoid hepatotoxic drugs, adjust drug dosages, select agents with minimal hepatic metabolism, regularly monitor liver function, and exercise caution when using combination therapies. If symptoms such as jaundice, worsening fatigue, or discomfort in the hepatic region occur after starting medication, prompt medical evaluation is recommended.
When prescribing medications for patients with liver dysfunction, it is important to follow several key precautions—avoiding hepatotoxic drugs, adjusting dosages, selecting medications with minimal hepatic metabolism, regularly monitoring liver function, and exercising caution with combination therapy—in order to reduce additional drug-induced burden on the liver. If symptoms such as jaundice, worsening fatigue, or discomfort in the liver area occur after starting medication, prompt medical attention is advised.
1. Avoid hepatotoxic drugs: Clearly avoid known hepatotoxic agents such as acetaminophen (paracetamol) and certain antibiotics. These drugs can directly damage liver cells and exacerbate existing liver dysfunction. Alternative medications should be prescribed under a physician’s guidance.
2. Adjust drug dosage: Reduce the dose or extend the dosing interval according to the severity of liver impairment. When liver metabolism is compromised, standard doses may lead to drug accumulation and increase the risk of adverse effects.
3. Select drugs with minimal hepatic metabolism: Prioritize medications that are primarily excreted via the kidneys or have low rates of hepatic metabolism to reduce metabolic stress on the liver and prevent systemic drug accumulation and potential toxicity.
4. Regularly monitor liver function: Routinely check liver function markers such as transaminases and bilirubin during treatment to dynamically assess liver status. If these indicators continue to rise, the medication regimen should be adjusted promptly.
5. Use combination therapy cautiously: Using multiple medications concurrently may worsen liver injury or cause drug interactions. Patients must inform their doctors of all current medications, including supplements, and should not add new products without medical advice.
In daily life, patients should strictly adhere to medical instructions without altering doses on their own, maintain a light and easily digestible diet while avoiding greasy and high-sugar foods, follow a regular sleep schedule and avoid staying up late, quit smoking and drinking alcohol, and engage in moderate physical activity to strengthen overall health and support liver recovery.
