ReviewDrug safety2018
Evidence-Based Recommendations to Improve the Safe Use of Drugs in Patients with Liver Cirrhosis.
Review in Drug safety, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Limited Evidence to Fully Determine the Implementation of Evidence-Based Practice by Healthcare Providers in Africa: A Systematic Review and Meta-Analysis.Journal of evidence-based medicine · 2025Pooled it
- Recommendations for the safe use of direct oral anticoagulants in patients with cirrhosis based on a systematic review of pharmacokinetic, pharmacodynamic and safety data.European journal of clinical pharmacology · 2024Pooled it
- Dose Recommendations for Common Drugs in Patients with Liver Cirrhosis: A Systematic Literature Review.Clinical drug investigation · 2023Pooled it
- Steatotic liver disease trajectory: A holistic EASL guidance on the multidisciplinary approach to screening and patient management.JHEP reports : innovation in hepatology · 2026Review
- Ethanol as a Modifier of Drug Toxicity in Humans: Pathways of Toxicity and Organ-Level Consequences.International journal of molecular sciences · 2026Review
- Application of the Child-Pugh Classification in Japanese Drug Labeling: A Cross-Sectional Analysis of Contraindications, Dose Recommendations, and Pharmacokinetic Rationale.Therapeutic innovation & regulatory science · 2026Article
- Dose Recommendations for Drugs in Patients With Liver Cirrhosis (The ALIVe Study): Protocol for a Multiphase Validation and Consensus Study.JMIR research protocols · 2026Article
- Recommendations on Drug Selection and Dose Adjustment for Patients with Liver Cirrhosis: Results from a Multidisciplinary Expert Panel.Clinical drug investigation · 2026Article
- Using Physiologically Based Pharmacokinetic Modeling and Simulations to Predict Antihypertensive Drug Doses in Cirrhotic Patients.Journal of clinical pharmacology · 2026Article
- A practical assessment protocol for clinically relevant P-glycoprotein-mediated drug-drug interactions.Frontiers in pharmacology · 2024Article
- Changing Prevalence of Medication Use in People with Cirrhosis: A Retrospective Cohort Study Using Pharmaceutical Benefits Scheme Data.Drugs - real world outcomes · 2023Article
- Innovations, Opportunities, and Challenges for Predicting Alteration in Drug-Metabolizing Enzyme and Transporter Activity in Specific Populations.Drug metabolism and disposition: the biological fate of chemicals · 2023Article
- Clinical Guideline on Perioperative Management of Patients with Advanced Chronic Liver Disease.Life (Basel, Switzerland) · 2023Review
- Metamizole-Associated Risks in Decompensated Hepatic Cirrhosis.Deutsches Arzteblatt international · 2022Article
- Management of Pharmacologic Adverse Effects in Advanced Liver Disease.Clinical drug investigation · 2022Review
- Inconsistencies and Ambiguities in Liver-Disease-Related Contraindications-A Systematic Analysis of SmPCs/PI of Major Drug Markets.Journal of clinical medicine · 2022Article
- Safe use of radiopharmaceuticals in patients with chronic kidney disease: a systematic review.EJNMMI radiopharmacy and chemistry · 2021Review
- Managing medicines in alcohol-associated liver disease: a practical review.Australian prescriber · 2021Review
- Improving Medication-Related Outcomes in Chronic Liver Disease.Hepatology communications · 2020Review
- Spontaneous adverse drug reaction reports on patients with cirrhosis: analysis of the nature, quantity and quality of the reports.European journal of clinical pharmacology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 7 institutions in 1 country.
Funding
Abstract
introductionThe presence of liver cirrhosis can have a major impact on pharmacodynamics and pharmacokinetics, but guidance for prescribing is lacking.
objectiveThe aim of this study is to provide an overview of evidence-based recommendations developed for the safe use of drugs in liver cirrhosis.
methodsRecommendations were based on a systematic literature search combined with expert opinion from a panel of 10 experts. The safety of each drug was classified as safe, no additional risks known, additional risks known, unsafe, unknown or the safety class was dependent on the severity of liver cirrhosis (Child-Pugh classification). If applicable, drug-specific dosing advice was provided. All recommendations were implemented in clinical decision support systems and on a website.
resultsWe formulated 218 recommendations for a total of 209 drugs. For nine drugs, two recommendations were formulated for different administration routes or indications. Drugs were classified as 'safe' in 29 recommendations (13.3%), 'no additional risks known' in 60 (27.5%), 'additional risks known' in 3 (1.4%), and 'unsafe' in 30 (13.8%). In 57 (26.1%) of the recommendations, safety depended on the severity of liver cirrhosis and was 'unknown' in 39 (17.9%) recommendations. Large alterations in pharmacodynamics were the main reason for classifying a drug as 'unsafe'. For 67 drugs (31%), a dose adjustment was needed.
conclusionsOver 200 recommendations were developed for the safe use of drugs in patients with liver cirrhosis. Implementing these recommendations into clinical practice can possibly enhance medication safety in this vulnerable patient group.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.