62 y/o M PMH of hep C cirrhosis, HTN, and anemia presents with fever to 101.6 and diffuse abdominal pain. Your patient has jaundice and abdominal distension and tenderness with shifting fluid wave. You work him up with labs, including a tap to rule out SBP. Can you safely use tylenol to control his fever?

Tylenol has been shown to be safe in patients with liver disease. Acetaminophen has been studied in a variety of chronic liver diseases without evidence of increased risk of hepatotoxicity at currently recommended dosesĀ (4 g/d). Tylenol is also preferred to NSAIDs for fever control due to the risk of GI bleed and renal injury.

Benson GD, Koff RS, Tolman KG. The therapeutic use of acetaminophen in patients with liver disease. Am J Ther. 2005 Mar-Apr;12(2):133-41.