What medications are contraindicated for patients with liver disease?
Dec 03, 2025
Source: Cainiu Health
Dr. Gao Jun
Introduction
In general, patients with liver disease must strictly avoid medications known to have definite hepatotoxicity, including common drugs such as acetaminophen tablets, isoniazid tablets, methotrexate tablets, ketoconazole capsules, and diclofenac sodium sustained-release tablets. Patients with liver disease must clearly inform their medical history before taking any medication and strictly follow medical advice when selecting drugs. Regular monitoring of liver function is necessary in daily management, and self-administration of medications with unknown ingredients should be avoided.
Under normal circumstances, patients with liver disease must strictly avoid medications known to have definite hepatotoxicity. Common examples include acetaminophen tablets, isoniazid tablets, methotrexate tablets, ketoconazole capsules, and diclofenac sodium sustained-release tablets. Detailed explanations are as follows:
1. Acetaminophen tablets: The main ingredient is acetaminophen, which is relatively safe at standard doses. However, in patients with liver disease, reduced liver metabolism means even standard doses may cause liver damage. Overdose can directly lead to hepatocyte necrosis; therefore, this drug is contraindicated in patients with liver disease.
2. Isoniazid tablets: The core component is isoniazid, an anti-tuberculosis agent whose metabolites are hepatotoxic. In patients with liver disease, the drug accumulates in the liver, easily inducing drug-induced hepatitis and exacerbating hepatic inflammatory responses. Thus, it is clearly listed as a contraindicated medication.
3. Methotrexate tablets: The primary active ingredient, methotrexate, exerts its effect by inhibiting cellular metabolism. This drug is metabolized in the liver and interferes with normal hepatocyte function. Its use in patients with liver disease may lead to liver failure, and it is clinically prohibited in such patients.
4. Ketoconazole capsules: The main component, ketoconazole, is an antifungal agent. Its metabolic process directly damages mitochondrial structures in liver cells, leading to hepatocellular degeneration and necrosis. In patients with liver disease, the risk of liver injury increases sharply; hence, strict avoidance is required.
5. Diclofenac sodium sustained-release tablets: The main ingredient, diclofenac sodium, is a non-steroidal anti-inflammatory drug (NSAID). It is metabolized in the liver, and its metabolites are directly toxic to hepatocytes. Use in patients with liver disease increases the burden on the liver and may trigger or worsen liver injury, so it must be avoided.
Prior to taking any medication, patients with liver disease must clearly inform their healthcare providers of their medical history and strictly follow medical advice when selecting drugs. Regular monitoring of liver function is essential in daily management. Patients should avoid self-medicating with drugs of unknown composition, and must use medications scientifically to protect liver function.
