Since the liver is the main The myopathy may be dose-related and is characterized by muscle aches and/or weakness in conjunction with increases in creatine phosphokinase (CPK) values exceeding 10 times the upper limit of normal. or their dosage modified in patients with liver disease. must be carefully considered in order to avoid adverse effects. HMG-CoA reductase inhibitors are extensively metabolized by the liver. WebMD provides common contraindications for Zovirax Oral. Patients with renal impairment may be at greater risk for neuro- and nephrotoxicity (including further deterioration in renal function, tubular damage and acute renal failure) from acyclovir due to decreased drug clearance. Intravenous acyclovir should be administered over a one-hour period accompanied by adequate hydration. ScienceDirect ® is a registered trademark of Elsevier B.V.Copyright © 2006 Elsevier Ltd. All rights reserved.ScienceDirect ® is a registered trademark of Elsevier B.V. WAKIX prolongs the QT interval. (Outlines changes in the kinetics and dynamics of drugs, and the effect this has on their use. Caution should be exercised when using these agents in diabetic patients and close monitoring is recommended.Moderate Potential Hazard, Moderate plausibility. To read this article in full you will need to make a paymentPotential drug–drug interactions and adverse drug reactions in patients with liver cirrhosis.Pharmacokinetics and dosage adjustment in patients with hepatic dysfunction.Clinical pharmacokinetic and pharmacodynamics considerations in patients with liver disease. Acyclovir should be administered after hemodialysis. A lower initial dosage may be appropriate, and clinical monitoring of liver transaminase levels according to the individual product package labeling is recommended. )We use cookies to help provide and enhance our service and tailor content and ads. WAKIX is contraindicated in patients with severe hepatic impairment. Some others such as pitavastatin and simvastatin, require a dose reduction when used in this group of patients. HMG-CoA reductase inhibitor therapy should be withdrawn if markedly elevated CPK levels occur or if drug-related myopathy is diagnosed or suspected.Moderate Potential Hazard, Moderate plausibility. Study Casts Doubt on Value of Cholesterol Drugs )(a state-of-art and comprehensive review of the issues associated with prescribing in patients with liver disease)(Comprehensive up-to-date review article detailing how and when the disposition of drugs is affected in liver disease. Hepatotoxic drugs. Nonsteroidal anti-inflammatory drugs should be avoided, as they are a common cause of adverse drug reactions (renal failure and gastrointestinal bleeding) in this population. Therapy with HMG-CoA reductase inhibitors should be administered cautiously in patients with a history of liver disease and/or heavy alcohol use. Applies to: CNS DisorderCognitive impairment (e.g., memory loss, forgetfulness, amnesia, memory impairment, confusion) have been observed in patients receiving statins. Applies to: Renal DysfunctionSome HMG-CoA reductase inhibitors such as fluvastatin, have not been studied in patients with severe renal impairment or end-stage renal disease. Applies to: hemodialysisAcyclovir is substantially removed by hemodialysis. Since the liver is the main site of drug detoxification and elimination in the body, patients must be carefully assessed for the need for therapy. Medications both over-the-counter and prescription are one of the common ways people inadvertently injure their liver. Applies to: Liver Disease, Electrolyte Abnormalities, Hypernatremia, Phosphate Imbalance, Magnesium Imbalance, Asphyxia, CNS Disorder, Hyponatremia, Dehydration, Hypocalcemia, Hypercalcemia, Acidosis, AlkalosisAcyclovir, particularly when administered intravenously in higher dosages, may occasionally produce neurotoxicity characterized by lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, or coma. Statin discontinuation 60 % following 6 hours of dialysis can Still Benefit Your Heart Select one or more newsletters continue... Severe hepatic impairment 75 or Older prescription drugs, over-the-counter medicines and natural products particularly when drug... Most recent data and includes a section on guidance produced by FDA and EMA Potential Hazard, Low plausibility when! ) Bircher J. Benhamou J.-P. McIntyre N. Rizzetto M. Rod_es J cirrhosis of any aetiology viral... 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