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.
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. (In the case of the latter, you should consult your doctor first, but completely avoid it in your 3rd trimester)
Luckily, a low dose of paracetamol is perfectly safe for everyone with liver disease. That means you can take 4 to 6 tablets in one day. Non-steroidal anti-inflammatory drugs like ibuprofen and aspirin are not the best choice of painkiller for people with liver disease as they can affect the kidneys.
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.
NSAIDs and aspirin should be avoided in patients with advanced CLD or cirrhosis. Low-dose acetaminophen should be used instead of NSAIDs.
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.
For people with liver disorders, ibuprofen use has adverse effects. The medication could worsen liver disease since it impairs the liver's ability to detoxify toxic compounds from the bloodstream.
Neuropathic Agents
The anticonvulsant medications, such as gabapentin and pregabalin (Lyrica) are not hepatically metabolized and frequently used to treat neuropathic pain.
Considering the relative risks and alternatives, acetaminophen is the best option for pain relief in patients with chronic liver disease.
Certain NSAIDs such as diclofenac and naproxen have been associated with hepatotoxicity. Therefore, low-dose acetaminophen (2 grams or less/day on non-consecutive days) is preferred over NSAIDs in patients with chronic liver disease.
The maximum dose within a 24-hour period must never be exceeded. 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.
What a paracetamol overdose does to your body. Paracetamol itself is not toxic, but in large amounts it overwhelms the body's ability to process it safely. This can lead to build up of a toxic metabolite (or break-down product), which binds to liver cells, causing these cells to die.
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.
Naproxen. Another anti-inflammatory drug, which works much like ibuprofen. Some studies show this may be a better choice than ibuprofen for people at risk for heart disease. Aspirin.
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.
French fries, wafers, burgers, and pizzas do no good to your liver. These food items are high in saturated fat or trans-fat content and are difficult to digest. In other words, your liver needs to work hard to process these food items.
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.
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.
Acetaminophen is generally considered safer than other pain relievers. It doesn't cause side effects such as stomach pain and bleeding.
Ibuprofen is considered to be among the safest NSAIDs and is generally well tolerated but can, nevertheless, rarely cause clinically apparent and serious acute liver injury.
For instance, nonsteroidal, anti-inflammatory drugs such as ibuprofen and naproxen, they should be avoided in patients with cirrhosis, because when the liver is scarred, there's a greater chance of hurting the kidneys with these types of medications.
Medication safety in NAFLD/NASH
People with cirrhosis must avoid pain medications called Non-Steroidal Anti- Inflammatories (NSAIDS). These include over-the-counter medications such as ibuprofen (Motrin®, Advil®), naproxen (Aleve® or Naprosyn®), as well as some prescription medications.