Painkillers are one of the most popular types of drugs used for headaches, back pain, cramps during menstrual cycles, toothache, and muscle pain. The fact that such drugs are easily obtainable leads to some misconceptions about their safety. The truth is that some pain medications may have some impact on the performance of the kidneys, especially if they are used too frequently, in large amounts, or if the patient has other problems with the urinary or circulatory system.
Which painkillers can affect the kidneys?
Non-steroidal anti-inflammatory drugs (NSAIDs) should be singled out. They include ibuprofen, naproxen, and diclofenac, which have certain effects. In essence, these medicines have such properties because of their ability to reduce the concentration of substances named prostaglandins, which contribute to pain and swelling. Moreover, one has to remember that prostaglandins are very important, as they take part in the regulation of blood flow to the kidneys. Blocking prostaglandins means that renal blood flow will be decreased in people vulnerable to such a decrease. Whether or not the risk of developing certain damage after taking NSAIDs depends on many factors, such as dosage, duration of treatment, age, hydration of the individual, and health status as well.
When does the risk become higher?
Risk can be heightened when NSAIDs are used regularly or when dehydration occurs. Vomiting, diarrhoea, high fever, and lack of fluid reduce already compromised blood flow. NSAID use in this case puts extra stress on kidney function. Those suffering from chronic kidney disease, heart failure, uncontrolled hypertension, or diabetes, as well as older people, are particularly at risk. Some drug combinations can also increase risk, including combining NSAIDs with some diuretic medicines.
What about common medicines for headaches or fever?
There are differences in the effect of painkillers on the kidneys. Paracetamol/acetaminophen at the recommended dose is thought to have less of an effect than NSAIDS. At the same time, greater doses of paracetamol/ acetaminophen can give rise to severe liver damage. Additionally, consumers need to be careful when taking cold and flu medications as they may contain paracetamol without them realising it. The safest way to use any medication is not to assume it is harmless because they bought it over the counter.
What should you watch for?
In early stages of kidney injury, noticeable signs and symptoms may not always manifest. With serious impairment of the kidneys, there can be decreased urine production, swelling, extreme tiredness, nausea, or even shortness of breath, although these indicators are not a reliable method of detecting the problem in its early stages. If one feels pain for days or weeks, that needs treatment; the focus should be on locating and treating the cause of the pain instead of trying to treat it continuously.
Pain medications play an important role in pain management, and they should not be a source of worry when used properly in the short term. Problems arise when they are excessively employed without regard to dose, length of use, hydration, and individual risks. If you have kidney problems or other chronic diseases, or you regularly need the drugs, consult with your physician regarding the safest forms and dosages of these medications. The aim is not to avoid the use of pain relievers but to use them in the most effective and appropriate manner.
The author is the additional director - Nephrology and Kidney Transplant, Aakash Healthcare Multi-Speciality Hospital, Dwarka.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
