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Hepatitis A is inflammation of the liver caused by infection with the…

- - - - metoclopramide (maximum duration of treatment 5 days) or cyclizine at normal dosages, if liver impairment is mild.
      - seek specialist advice if severe liver impairment
    - - Chlorphenamine at normal dosage at night (avoid in severe liver impairment). The dosage can be increased to every 4–6 hours if itch is severe.
      - Ursodeoxycholic acid, colestyramine, and corticosteroids — seek specialist advice before prescribing
      - Simple measures- cool clothing, washes, environment
    - - Paracetamol normal doses can be used unless evidence of moderate or severe liver impairment. Serum bilirubin >300mmols/l, or prothrombin time >3 seconds, dose would be reduced to 1g two or three times a day.
      - Ibuprofen
      - Weak opioid (such as codeine) if liver impairment mild. Avoid codeine in severe liver impairment as it enhances sedative effects and reduces drug clearance