Safe medication use in liver cirrhosis

Liver cirrhosis is a severe disease that has an impact on the pharmacokinetics and pharmacodynamics of a drug. Our Dutch website provides information for the safe use of more than 300 drugs in patients with liver cirrhosis. For each drug, a specific advice about the safety and dosing in patients with cirrhosis is given. For some drugs, the advice is depending on the severity of cirrhosis of the patient expressed in Child-Pugh class. 

This English website was built as example and contains only information on a few medicine groups yet (see Drugs).

Recently, Drug Safety published an overview of our recommendations in English.

How does this website work?

In the search field you can enter the drug of interest and click on it when it appears. The drug names are currently only available in Dutch. Drugs have been evaluated per drug class (if applicable), so you will also see the advice for other drugs in the same class. Not all drugs have been evaluated yet. If a drug has not been evaluated, you are not able to find it.

How have the recommendations on this website been developed?

The recommendations were established by combining literature review and expert opinion. A pharmacist from the Health Base Foundation performed a literature review per drug (class) and wrote a concept assessment report. This report was discussed with an expert panel and they added their comments. The final report is a combination of literature and expert opinion. This method has been published in BMJ Open

How is this website funded?

The Health Base Foundation developed the recommendations on this website. The information from Health Base is evidence-based and is being funded by healthcare professionals using the information. Health Base is not financed by the pharmaceutical industry. For the development of this website, a grand was received from ZonMw, The Netherlands Organization for Health Research and Development (grant no. 836044009).

Expert panel

The following healthcare professionals are members of the expert panel 'drugs in liver cirrhosis': 

  • R.A. Weersink MSc, Health Base Foundation/University of Groningen, Houten/Groningen
  • Dr. M. Bouma, Department of Guideline Development, Dutch College of General Practice, Utrecht
  • Prof. dr. D.M. Burger, Department of Pharmacy, Radboud University Medical Center, Nijmegen
  • Prof. dr. J.P.H. Drenth, Deparment of Gastroenterology, Radboud University Medical Center, Nijmegen
  • Dr. N.G.M. Hunfeld, Department of Pharmacy and department of Intensive Care, Erasmus University Medical Center, Rotterdam
  • Prof. dr. H.J. Metselaar, Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam
  • Drs. M. Monster-Simons, Dutch Medicines Evaluation Board, Utrecht 
  • Drs. E. H. Okel, Pharmacy de Brug and Pharmacy Randstad, Almere
  • Dr. S.D. Borgsteede, Department of Medication Surveillance, Health Base Foundation, Houten

Declaration of interest

R.A. Weersink Msc, dr. M. Bouma, dr. N.G.M. Hunfeld, drs. M. Monster-Simons, drs. E.H. Okel and dr. S.D. Borgsteede: no conflict of interest

Prof. dr. D.M. Burger has received research grants from MSD, BMS and ViiV Healthcare. He has performed teaching for Gilead, MSD, Abbvie, BMS and ViiV Healthcare. All payments have been made to his employer: the Radboudumc in Nijmegen.

Prof. dr. J.P.H. Drenth has received research grants from Abbvie and Janssen. He is member of scientific advisory boards of Abbvie, BMS, Gilead, Janssen and Merck. All payments have been made to his employer: the Radboudumc in Nijmegen.

Prof.dr. H.J. Metselaar has received research grants from Abbvie, Astellas, Novartis and Gilead. He is member of scientific advisory boards of Abbvie, Astellas and Novartis