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What Over-the-Counter (OTC) Medications are Safe for Liver Transplant Recipients?


over the counter pills

For liver transplant recipients, the over-the-counter (OTC) medication aisle at your pharmacy can be an overwhelming and dangerous place. Inappropriate OTC medications can affect how well your transplant medications work, worsen or add additional side effects, or affect other medical problems that could impact your quality and quantity of life.

Rules for using over-the-counter medication

The Penn Medicine Liver Transplant Team provides some general rules for its patients.

  • Look at the active ingredient section of the product label to identify safe/unsafe medications (similarly to how you look at food labels).
  • Only acetaminophen (Tylenol®) can be safely taken for aches and pains. Do not exceed 2,000 mg per day. Anti-inflammatory (NSAID) medicines such as ibuprofen (Advil®, Motrin®) naproxen (Aleve®) and aspirin (taken above the one tablet a day dose) can be harmful to your kidneys when you are on antirejection medication.
  • Avoid products containing the decongestant pseudoephedrine (Sudafed®) as this can raise you blood pressure and heart rate.
  • Single active ingredient products such as Tylenol® (acetaminophen) are better choices then multi-active ingredient products that may contain both safe and unsafe ingredients.
  • Do not exceed the dose on the package or the dose recommended by the transplant team.
  • Patients with diabetes should try to use sugar-free cough syrup.
  • Show this list to your pharmacist and ask for their help in selecting the right medication for your symptoms.

Below is a list of over-the-counter medications that the Penn Medicine Liver Transplant Team allows. If your problems/symptoms are not responding to these medications or get worse, please call.


Abdominal bloating/Gas Simethicone >Mylicon®>, Mylanta gas®>,Gas-X®>, Digel®>, Gelusil®>
Allergies Diphenhydramine, loratadine, cetirizine Benadryl®, Claritin®, Zyrtec®, but not Claritin-D® or Zyrtec-D®
Sneezing, Runny nose Chlorpheniramine Chlor-trimeton®
Constipation >Docusate, senna, psyllium, bisacodyl, polyethylene glycol 3350 Metamucil®, Colace®, Peri-colace®, Senokot®, Dulcolax®, Miralax®
Congestion Guaifenesin Mucinex®, Robitussin® (plain)
Cough Dextromethorphan Robitussin CoughGels®, Robitussin DM® (contains guaifenesin), Coricidin® HBP Cough & Cold (contains chlorpheniramine)
Diarrhea *Notify a coordinator if you have diarrhea for greater than 24 hours or if you also have fever and abdominal pain* Loperamide *Do not exceed the recommended doses of any medications* Imodium® *Keep yourself well hydrated by drinking at least EIGHT glasses of fluid a day and increase your salt intake*
Low-grade fever, joint aches,headache Acetaminophen *Notify a coordinator if your fever rises above 100.4 degrees* Tylenol ® (plain) *You can take up to 2,000 mg in a 24 hour period*
Nausea Calcium carbonate, fructose/dextrose/phosphoric acid Tums®, Emetrol®
Sore throat Menthol, benzocaine Luden’s®, Vicks®, Chloraseptic®, NICE®, Halls®

Patients from other liver transplant programs can check with their team for medication recommendations.

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The Penn Medicine Transplant blog features short postings with news about the transplant program at Penn Medicine, notices about upcoming events and health information. Subscribe to the blog and stay connected with Penn's Transplant Program!

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