Liver Transplant (cont.)
Before undergoing liver transplantation, people who have liver disease should avoid medications that may further damage the liver.
- Large amounts of acetaminophen (Tylenol) may be harmful and can damage the liver. (Acetaminophen is contained in many over-the-counter drugs; therefore, patients with liver disease must be particularly watchful.) Sleeping pills and benzodiazepines (Valium and similar medicines) can build up faster in the blood when the liver doesn't work well. They can make a person confused, worsen existing confusion, and, in some cases, cause coma. If possible, try to avoid taking these medicines.
- Alcohol is an ingredient in some cough syrups and other medications. Alcohol can severely damage the liver, so it is best to avoid alcohol-containing medications.
- The female transplantation patient should not take oral contraceptives because of the increased risk of blood clot formation.
- No transplant recipient should receive live virus vaccines (especially polio), and no household contacts should receive these either.
- Pregnancy should be avoided by transplant recipients until at least 1 year after transplantation. If a woman wants to become pregnant, she should speak with her transplantation team regarding any special risks. In many cases, women successfully become pregnant and give birth normally after transplantation, but they should be carefully monitored because of the higher incidence of premature births. Mothers should avoid breastfeeding because of the risk of the baby's exposure to the immunosuppressive medicines through the milk.
Robert M McNamara, MD, FAAEM
Francisco Talavera, PharmD, PhD
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