Dear Editor:

Which analgesic-antipyretic would be reckoned comparatively safe for usage in patients suffering from viral hepatitis?

HNL

Dear Dr. HNL:
In patients with mild to moderate chronic hepatitis, any analgesic-antipyretic is likely safe. In acute hepatitis, I try to avoid these drugs, particularly if the hepatitis is severe. In advanced chronic hepatitis with cirrhosis, acetaminophen up to 3 grams daily appears to be safe; however, NSAIDs or ASA can affect platelet function, induce gastric erosions or reduce renal function in some patients and should be avoided.
Emmet Keeffe, MD

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