Ibuprofen or acetaminophen?

I forgot which pain relief medicine is safe for PSC for aches and pains. Please help

Acetaminophen. No more than 3000 mg in a 24 hour period.

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Thanks! I’ve been experiencing a lot of pain today. I had forgotten as well.

My coordinator told me Tylenol is OK, but no more than 2000 mg a day.

Ibuprofen. My daughter’s doc said to avoid acetaminophen because it can affect the liver.

Catcusgirl your information is not correct. Ibuprofen is an NSAID and they are to be avoided with liver disease. I’m not sure where your daughter was told this but it is incorrect. Ibuprofen will increase liver damage.


Rather I should have said her doctor is incorrect. Is he a hepatologist? I’m really surprised she was told that.


Actually both are fine at normal doses until end stage liver disease. Ibuprofen isn’t appreciably metabolized in the liver, unlike acetaminophen. The issue with acetaminophen is that there is a very fine line between normal dose and hepatotoxicity. The issue with Ibuprofen is that it can exacerbate side effects caused by cirrhosis like ascites and portal hypertension/esophageal varices.

Perhaps every hepatologist approaches this differently, but mine made it very clear in no uncertain terms that with PSC I was not to have any NSAIDS. I guess the patient will have to make the decision on this the best they can. And with my PSC I certainly had end-stage liver disease resulting in transplant. They also made it clear post transplant, absolutely no NSAIDS either.

That’s my understanding on this issue too. Acetaminophen is obviously directly acting on liver cells. With smaller dose, it’s just less damage.
Actually at end stage of liver disease, some Mayo doctors recommend to use small dose of acetaminophen if you have to (I’d rather to accept the pain instead of taking any unnecessary medication). The reasoning is that you are going to loose your liver anyway. But you must protect any other organs, including kidney.

I worded it poorly, but the point I was trying to convey is that ibuprofen does not cause liver damage and is generally fine up until end stage liver disease where it is contraindicated due to side effects caused by cirrhosis. Acetaminophen is likely fine throughout all stages. My first two hepatologists likened acetaminophen to alcohol - probably won’t contribute to progression, but can’t say for sure - and felt that ibuprofen was the better alternative. My last three hepatologists didn’t have a preference.