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COX-2 is normally inactive, but can be turned on during inflammation to produce pro-inflammatory prostaglandins

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Routine medical review is advisable for fatty liver patients who: Require paracetamol or other analgesics on most days Have not had liver function tests within the past 612 months Experience new or worsening pain requiring escalating medication Take multiple medications that may interact or affect the liver Engage in chronic alcohol misuse whilst using paracetamol regularly Have other chronic conditions such as diabetes or cardiovascular disease Your GP can arrange appropriate liver function monitoring, assess the stage of liver disease, and develop a comprehensive pain management plan tailored to your individual circumstances

(6) Henning RJ, Sawmiller DR

and James, S.J