Studies from 2010 indicate that “Patients with impaired renal or hepatic function may have difficulty clearing or metabolizing opioids and concurrent medications, leading to increased risk of adverse events.”

At the time of his arrest, Mr. Smith was on Ibuprofen, HCTZ, Griseofulvin, Methadone, Diazepam, and Ambien. With the exception of HCTZ, these medications are metabolized through the liver, and are cautioned in hepatic impairment. Diazepam is not recommended for use in patients with severe hepatic impairment.

The Full Prescribing Information on Methadone provided to the FDA indicates “Methadone has not been extensively evaluated in patients with hepatic insufficiency. Methadone is metabolized by hepatic pathways, therefore patients with liver impairment may be at risk of accumulating methadone after multiple dosing.”

Adding Wellbutrin to an already overloaded liver would induce new side effects or potentiate any of the side effects listed under any of the other medications he was on. The most likely side effects to be potentiated would be those that are listed under Wellbutrin as well as the other medications above: Those side effects are headache, dizziness, agitation, lethargy, memory impairment, hallucinations, concentration disturbance, and confusion.


This month we are discussing DUI and Liver Failure by way of a case study.  The blog topics for this month are:

  • Case Summary (4/1/16)
  • What does the liver do? (4/8/16)
  • Liver disease and medications (4/15/16)
  • Educating about medications (4/22/16)

Note: To see all posts in this topic, click here

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