Opioids Oxycodone causing increased levels of liver enzymes

[evo4ever]

Hello all.

I'll try and keep this short.. Over the past 12 months (probably longer) I've had raised liver enzymes due to the meds I'm on so much so that I've developed very mild pain/discomfort in my liver area which quickly comes and goes. I'm on 4 different meds and I'm almost convinced the Oxycodone is the worst offender. I take 30mg 4x a day (sometimes more depending on my pain levels). I done a little experiment to try and prove it's the Oxycodone by temporarily reducing my dose and after a liver function test my liver enzymes came down but still not to normal levels probably because of the other meds I'm taking.

So I done more research online to determine how the meds I'm on are metabolized and I came to the conclusion that ALL of them are metabolized via the CYP450 pathway. So I've been doing even more research on which opioids are not metabolized via the CYP450 pathway and the most common ones are Morphine, Hydromorphone, and Oxymorphone which are metabolized via the UGT2B7 pathway. Do you think it's worth replacing the Oxycodone with one of the aforementioned opioids at the equivalent dose to see if my CYP450 levels come down? I mean it could have a positive effect on my liver's overall health by lowering my CYP450 levels. Is it worth a try?

Help greatly appreciated!!

 

[Deleted member 554582]

Could be anything..depends on Ur liver function...Do u got hepatitis or not-this is of real significance..don't know Opies to raise liver enzymes if u haven't already disrupt liver function,all combo of Ur meds could have some negative impact..,alcohol for sure elevate liver enzymes...some meds also,but as to oxy,if Ur liver is not compromize already...I don't think that it is a reason for that..,also elevated liver enzymes can't say much of Ur liver status..old school liver biopsy remains the golden standard to show current status of the liver....along with fibroscan,which could measure eventually hardening of the liver tissue....elevated enzyme show only that something is not right in this particular moment....medics look for elevated alat,asat,ggt enzymes,not cyt.enzyme

 

[Them Witches]

I seriously doubt the 1/2 a pea size Oxycodone Hydrocloride 30mg tablets are causing your issue. From 2001 to the present day, I cannot remember all of the blood panel work-ups I've done. I had Hep-C from 2002 to 2008 and I cured it with "standardized or 90% pure" Milk Thistle Extact, Grape Seed Extract, Green Tea Extract, and Cranberry Extract. On an empty stomach it must be taken with oatmeal because the oats help keep the herbs/plants in the small intestine long enough for maximum first-pass metabolism. After a little over a year, the test came back negative and the following 4 Hep-C test equal negative to present date yet there are details :

Anyone previously infected now negative will have this = a reactive (positive hepatitis C RNA tests means you were exposed to the virus at some point, but the infection is no longer active. Once exposed, your body produces antibodies to fight the virus, and these antibodies will remain in your blood for life.

Family genetics...? Alcohol...? NSAIDS...? Diet...? Hydration...? Other medications...? Stress...?
Illicit narcotic abuse all manners...? IV use and IV sharing...? Hep-C Test...? Hep-C symptoms...?

 

[Them Witches]

Another thing is, all my medicines are the tiniest of pills. All prescribed by design for less impact on the liver. You need to dissolve the Roxi under the tongue anyways. Snorting it sucks compared. Even IV Oxycodone only feels a tiny bit better than dissolving under the tongue. Dissolve with Ativan and Clonidine... Now were cooking gasoline.

that's just it. all these poor people in pain that cannot get an Rx kill their liver with NSAIDS.

 

[evo4ever]

Every medication I'm on is contributing to my raised liver enzymes, I've already proven that when I temporarily cut down on my oxycodone intake. It's definitely not Hepatitis either because I was tested for it back in Jan/Feb and it came back negative. Also I've had 2 ultrasound scans on my liver this year and they came back normal. I don't drink, smoke, or take illicit drugs or anything OTC, and I've got a healthy diet. So it's a bit obvious it's the meds I'm on and again I think I've found the main culprit IE oxycodone. I'm going to discuss this with my GP and try and move over to the equivalent dose of Morphine, it would be very interesting to see how my liver responds.

 

[Them Witches]

The best wishes for getting this worked out. Seems I am in luck that Oxycodone, Methadone, and all the other medications I take are not hurting my liver or kidneys.

There are not many people in my pain management having the effects your having. Again, I hope all this gets worked out for you and your GP and You develop a healthy plan of action.

I do not like rotating opiates/opioids very often unless it is 100% required. On rotation medical data suggests the patient should be rotated with a 25% MME drop so the new opioid does cause I'll side-effects. The heck with that. 25% is too much. I guess some patients receive heavy side-effects from narcotics. After 5+ years of taking them those unwanted effects are basically non-existent.

 

[chippermonk]

I'm not expert on any of this, but what does your doctor say? Do they think you have a liver problem ? I gather you have high levels of CYP450? From what I just read ( thank you Google) CYP450 metabolizes oxycodone but it is not induced by oxycodone, so it doesn't seem like it should raise levels.
Also, from what I read, high levels of CYP450 are not necessarily dangerous. However it might cause you to metabolize drugs differently. For example, people with naturally high levels of CYP2D6 ( one of the CYP450s) for genetic reasons are known for metabolizing codeine better and thus getting stronger effects off of it. I assume this applies to oxycodone as well.
Thus, having high levels of CYP450 might have an effect on how you feel the oxycodone (and some other drugs too) but the oxy itself is not going to affect your liver enzymes. Nor are those high levels of CYP450 going to affect you badly per se, but perhaps the doctor might want to adjust your prescriptions some to reduce drug side effects if so.
But don't listen to me too seriously because I'm not an expert. Talk to your doctor. I'm sorry this worries you. One thing also to keep in mind, some people just naturally have higher levels of CYP450. Maybe your one of them?
Good luck