What it is
The liver does many jobs, including helping the body break down and clear many medicines, supplements and other substances. When the liver is inflamed or damaged, for example by a hepatitis infection, it may handle some of these substances differently than it did before.
A medication interaction happens when one substance changes how another works or how the body processes it. Interactions can involve prescription medicines, over-the-counter products, herbal products, vitamins, and even alcohol. Some interactions are minor, and others matter more depending on a person's health.
Older adults often take several medicines for different conditions, and the body's handling of medicines can change with age. That is one reason a full, up-to-date medicine list is useful when liver disease, hepatitis B or hepatitis C is being discussed. Hepatitis C can often be treated and cleared with modern antiviral medication, and hepatitis B is effectively managed with antiviral therapy and monitoring, so these conversations are often hopeful ones.
How it’s traditionally been approached
Traditionally, clinicians approach this topic by starting with a careful review of everything a person takes. This often includes prescriptions, over-the-counter pain relievers, cold and allergy products, supplements, herbal remedies, and alcohol use.
Doctors and pharmacists commonly check for interactions whenever a new medicine is considered, including antiviral medicines used for hepatitis B or C. Blood tests that look at liver function are one common way clinicians learn more about how the liver is doing, and they are interpreted by a licensed professional.
Pharmacists are often an additional resource, since they keep records of filled prescriptions and can flag possible interactions. Many people also use a single pharmacy so that their medicine history is easier to see in one place. Decisions about what to start, stop or change belong with a licensed clinician.
How the right doctor may help
The right doctor, such as one experienced in caring for older adults or in liver and hepatitis care, may help by looking at the whole picture: your health history, your liver, your other conditions, and everything you take. This is a possibility, not a promise of any particular outcome.
A visit generally begins with questions about your history and symptoms, and may include an exam and lab work if the clinician thinks it is appropriate. Bringing all your pill bottles, supplements and a list of over-the-counter products, in a bag or on paper, can make the conversation much more useful.
Questions you might ask include: Do any of my current medicines or supplements matter for my liver? Should I be screened or vaccinated for hepatitis, and is that right for me? If I need hepatitis treatment, how would it fit with the other medicines I take? Which over-the-counter products should I ask about first? Our Providers.plus directory and the Hepatitis in seniors listings can help you find licensed providers to talk with.
The whole-person view
Body, mind and stress affect one another. Managing several medicines, appointments and health worries can feel overwhelming, and stress can influence sleep, appetite and daily routines. Looking after the whole person, not only lab numbers, is a reasonable way to think about health at any age.
Some people find body-based support helpful for stress, and Somatic Experiences offers information on that approach. Others value talking things through with a professional, and Therapists.plus lists talk therapy providers. These are complements to, not replacements for, care from your doctor.
Keep in mind
- This page is educational and is not medical advice; only a licensed clinician can decide what is appropriate for you after an evaluation.
- Do not start, stop or change any medicine or supplement on your own. Ask your doctor or pharmacist first, since natural or over-the-counter products can also interact.
- Hepatitis screening and vaccination are conversations to have with a licensed clinician, and they may be especially relevant for some groups, such as people born in certain years, people who had a blood transfusion before 1992, or people born in regions where hepatitis B or C is more common.
- For emergencies such as confusion, severe abdominal pain, vomiting blood, or significant yellowing of the skin or eyes with fever, call 911. In a crisis, call or text 988.
Not sure where to start? Answer a few gentle questions and choose who you’d like to hear from.
Frequently asked questions
What are medication interactions with liver disease?
They are situations where a medicine, supplement or alcohol affects how another substance works, and liver disease may change how the body processes those substances. Whether an interaction matters depends on the person and the products involved. A licensed doctor or pharmacist can review your list and explain what applies to you.
Why are older adults more concerned about medication interactions and liver disease?
Older adults often take more medicines, and the body's handling of medicines can change with age. When liver disease or hepatitis is also present, more careful review may be useful. This does not mean a problem is certain, only that a regular medicine check with a clinician is a good idea.
Can hepatitis treatment interact with my other medicines?
It may, which is why clinicians review your full medicine list before recommending any hepatitis treatment. Hepatitis C can often be treated and cleared with modern antiviral medication, and hepatitis B is effectively managed with antiviral therapy and monitoring. Ask your provider how a possible treatment would fit with everything else you take.
Are over-the-counter medicines and supplements safe with liver disease?
It depends on the product and on your health, so the safest step is to ask a licensed clinician or pharmacist before using them. Many people forget to mention over-the-counter pain relievers, sleep aids and herbal products, but these belong on your medicine list. Supplements are not reviewed by the FDA the way prescription drugs are, so it is worth asking about them specifically.
Who should I talk to about medication interactions and liver disease?
Start with your primary care doctor or a clinician experienced in liver and hepatitis care, and involve your pharmacist as well. Bring every medicine, vitamin and supplement you use. You can find licensed providers through Providers.plus and our Hepatitis in seniors listings.
Should older adults be screened for hepatitis?
Whether screening makes sense is a conversation to have with a licensed clinician. Some people may be more likely to be asked about it, such as certain birth cohorts, people who received a blood transfusion before 1992, people who have injected drugs, and people born in regions with higher hepatitis B or C prevalence. Raising the question is simply a way to learn more, without judgment.
Educational resource. Hep Programs shares general information and connects people with independent doctors. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.