The greater the progression of liver
dysfunction, the greater the impairment
in drug metabolism.
Patients with asymptomatic
chronic liver disease without cirrhosis do not have liver dysfunction, and thus analgesic metabolism is similar to that in the general population. In patients with severe liver disease but not cirrhosis (eg, severe hepatitis), drug metabolism may be altered, and thus concerns and dose reductions, as discussed in this article, may be warranted.