Acetaminophen is harder on the liver than ibuprofen. The liver is the main organ responsible for breaking down acetaminophen. When taken occasionally, and at recommended doses (no more than 4,000 mg per day), it shouldn't cause any liver damage.
Paracetamol can be taken on an empty stomach, while it is best to take ibuprofen with food, or soon after. Abuse of paracetamol can cause damage on your liver, while abuse of ibuprofen can cause damage to your stomach or liver. It's safer to take paracetamol if you are pregnant than ibuprofen.
Acetaminophen (paracetamol), when taken in reduced doses (maximum 2–3 grams per day), is generally considered to be the safest pain relief option for your liver.
Ibuprofen is a safe NSAID, although, in rare instances, it can seriously harm the liver. The drug increases the aminotransferase enzyme (ALT) levels that are released when liver cells die or are damaged. The increase in ALT signifies liver damage or liver disease.
Acetaminophen or Tylenol® is the best known medication that can damage the liver. This medication is widely available without prescription and is present in many of the cold and flu remedies as well as in prescribed pain medications.
Acetaminophen remains the drug of choice for occasional use in patients with kidney disease because of bleeding complications that may occur when these patients use aspirin.
Ibuprofen has the highest liver safety profile among NSAIDs and showed no severe liver injury in larger studies. Along with paracetamol and aspirin, it is considered one of the most common over the counter NSAIDs sold in the world. Coxibs have currently replaced several NSAIDs due to safer GI profile.
Paracetamol overdose is one of the leading causes of acute liver failure. Adults can usually take one or two 500mg tablets every 4-6 hours, but shouldn't take more than 4g (eight 500mg tablets) in the space of 24 hours.
Paracetamol can cause acute liver damage especially in people with excessive alcohol intake, people with advanced liver disease (such as cirrhosis), or people with kidney disease. Aspirin relieves mild to moderate pain and treats fever. It has an anti-inflammatory effect and reduces swelling and inflammation.
Neuropathic Agents
The anticonvulsant medications, such as gabapentin and pregabalin (Lyrica) are not hepatically metabolized and frequently used to treat neuropathic pain.
HEPATOTOXICITY RISK FACTORS
While acute liver injury can occur when used at or below the recommended daily maximum dose (4000 mg)[4], paracetamol toxicity is often the result of ingestion of paracetamol over this maximum dose.
Considering the relative risks and alternatives, acetaminophen is the best option for pain relief in patients with chronic liver disease.
Because ibuprofen has a strong anti-inflammatory effect, it is more effective than paracetamol at controlling certain types of pain, including rheumatoid arthritis, period pain, and muscular injuries. Ibuprofen is also available in a variety of forms.
Taking 1 or 2 extra tablets is unlikely to harm you. Do not take more than 8 tablets in 24 hours. Taking too much paracetamol can be dangerous and you may need treatment.
The primary difference is that ibuprofen is a non-steroidal anti-inflammatory drug (NSAID), meaning that it treats inflammation. Paracetamol does not. For example, paracetamol can be taken to treat the pain of arthritis, but it will not treat the inflammation which is causing the pain.
Pain in your liver itself can feel like a dull throbbing pain or a stabbing sensation in your right upper abdomen just under your ribs. General abdominal pain and discomfort can also be related to swelling from fluid retention and enlargement of your spleen and liver caused by cirrhosis.
Stay Away From Fatty Foods
Eat too many foods that are high in saturated fat and it can make it harder for your liver to do its job. Over time it may lead to inflammation, which in turn could cause scarring of the liver that's known as cirrhosis.
Too Much Alcohol
Alcoholic fatty liver, which causes liver inflammation (alcoholic hepatitis), eventual scarring (cirrhosis) and even liver cancer, is a process that begins on as little as four drinks a day for men and two for women. By the time you show symptoms, your liver may be damaged beyond repair.
Foods that support liver health include berries, cruciferous vegetables, beans, whole grains, nuts, and fatty fish. Coffee and green tea contain antioxidants that are helpful for liver health.