- Fatigue is very common in cirrhosis, and is often multifactorial
- Potential contributing factors include pain, pruritus, anxiety, depression
- Treat the patient’s fatigue if it is affecting their quality of life or daily functioning
- At the end of life (last few weeks or days), as the patient’s condition deteriorates, certain non-pharmacological interventions will become unrealistic (e.g. exercise), and pharmacologic interventions may become less effective. Reassess patient’s GOC as appropriate
Consider non-pharmacological management in all patients where fatigue has a significant impact on patient’s quality of life
If non-pharmacological therapy alone fails, and fatigue is having a severe impact on the patient’s quality of life and ability to function, a trial of pharmacological therapy can be considered.
There is limited data in this area. This suggestion is based on expert opinion rather than strong evidence.
|Medication:||Recommended Dose||Additional information|
|Methylphenidate (Ritalin)||2.5mg to 5mg PO qAM and noon||
We gratefully acknowledge the Physician Learning Program for their design assistance.
This section was adapted from content using the following evidence based resources in combination with expert consensus. The presented information is not intended to replace the independent medical or professional judgment of physicians or other health care providers in the context of individual clinical circumstances to determine a patient’s care.
Authors (Alphabetical): Amanda Brisebois, Sarah Burton-Macleod, Ingrid DeKock , Martin Labrie, Noush Mirhosseini, Mino Mitri, Kinjal Patel, Aynharan Sinnarajah, Puneeta Tandon
Thank you to pharmacists Omer Ghutmy and Meghan Mior for their help with reviewing these pages.
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