Brief Answer:
You should take lower then normal dose as bioavalability is increased.

Detailed Answer:
Hello Dear,
Thanks for choosing HealthacreMagic for your query.
I am a Gastronterologist and would be addressing your query.
Have gone through your details and i appreciate your concerns.

As per your query answer is-
You should take a lower dose of morphine then a healthy individual.

Explaination is as below-
The efficiency of drug removal by the liver relies on blood flow in liver, capacity of liver enzymes to break it, and plasma protein binding. Cirrhosis affects all these processes and may also lead to formation of shunts by which a drug can escape hepatic elimination.As in fibrotic liver all the above three processes are hampered drug can't reach liver hence is not metabolised by it.

Advanced liver disease and cirrhosis alter the metabolism of morphine through a variety of mechanisms, including changes in pharmacokinetic behavior, altered accumulation of free drug in plasma(every drug is bound to component of blood called plasma).

The liver is the main site of metabolism for most opioids(Morphine). Metabolism of opiod takes place either by oxidation or glucuronidation both of these processes are severly impaired in liver disease.As a result, patients with cirrhosis have decreased drug clearance and increased bioavailability(opposite to what you are thinking), leading to drug accumulation in the body, especially with repeated administration.


As per the trials done by NCBI(United states funded government research facility)-
"Various studies have consistently shown that the half-life of morphine is prolonged in patients with cirrhosis. Compared with healthy individuals, in cirrhotic patients the half-life of morphine is approximately double (3 to 4 vs 1.5 to 2 hours), which is attributable to a reduction in total body clearance."

Therefore you have to take less then optimal doses of morphine so to avoid accumulation of morphine in body.

Hope i answeredyour query well.
Feel free to ask any other question if you have.

Regards.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
Go for liver surgery don't worry even liver trransplants are very successful these days and should be done if your doctor suggest you to get liver transplant.
Success rates are very high and transplant is usually very successful.

Regards.

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Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
I am sorry for that but lets hope that titre comes to normal in few more months of antiviraltherapy.
Till then you can use tramadol for pain also.Its more safer then morphine.


Thank you so much, dear.I wish you a great life ahead.

"Experience life in all possible ways — good-bad, bitter-sweet, dark-light, summer-winter. Experience all the dualities. Don’t be afraid of experience, because the more experience you have, the more mature you become.This pain is not to make you sad, remember. Thats where people go on missing. This pain is just to make you more alert–because people become alert only when the arrow goes deep into their heart and wounds them." -Osho

Get well soon.

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