Pain Medicines (Analgesics) FAQs

Dr. Saurin Shah MS
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Pain Medicines
Analgesics
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Many analgesics should not be used if there is decreased kidney function, because they reduce the blood flow to the kidney. Also, long term use with higher doses may harm normal kidneys. It is important to realize that, while helpful, these medicines are not completely without risk, and they should be used carefully. Kidney disease related to analgesics is preventable.

What are analgesics?

Analgesics are medicines that help to control pain and reduce fever, and some types also decrease inflammation. Examples of analgesics that are available over the counter are: aspirin, acetaminophen (Paracetamol) , ibuprofen, Ketoprofen and naproxen sodium, Diclofenac etc..

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Can pain killer medicines hurt kidneys?

Check with your doctor to be sure you can use these medicines safely, particularly if you have kidney disease. Heavy or long-term use of some of these medicines, such as ibuprofen,diclofenac, naproxen, and higher dose aspirin, can cause chronic kidney disease. Over-the-counter analgesics should not be used for more than l0 days for pain and more than three days for fever. If you have pain and/or fever for a longer time, you should see your doctor

If you have decreased kidney function, painkillers called NSAIDs are not recommended. Even with normal kidney function, you should use analgesics:

* Exactly as prescribed

* At the lowest dose possible

* For the shortest period of time


My doctor recommended that I take an aspirin every day to prevent heart attacks. Will this hurt my kidneys?

No. There is no evidence of risk regarding the regular use of aspirin in the small doses recommended for prevention of heart attacks. Use of a ‘baby aspirin’ (75-150 mg daily) is fine, even with reduced kidney function.


What analgesics are safe for people who have kidney disease?

Acetaminophen / Paracetamol / Tramadol remains the drug of choice for occasional use in patients with kidney. However, kidney patients who need to use acetaminophen habitually should be supervised by their doctors and be sure to avoid drinking alcohol while on this medicine.


What are NSAIDs? Are they safe to take?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a specific group of pain relievers. Some NSAIDs are available over the counter. This includes different brands of ibuprofen, naproxen sodium and ketoprofen.

NSAIDs are usually safe for occasional use when taken as directed, but if you have known decreased kidney function, they should be avoided. These medications should only be used under a doctor's care by patients with kidney disease, heart disease, high blood pressure or liver disease or by people who are over 65 or who take diuretic medications. NSAIDs may cause an increased risk of sudden kidney failure and even progressive kidney damage.


I have arthritis. What pain relievers can I take that won’t hurt my kidneys?

You should speak to your doctor about the best choice for you. In addition, if you have any of the medical conditions listed in the previous question, you should only use NSAIDs under your doctor's supervision.


Are there other side effects from taking aspirin and NSAIDs?

Yes. The development of stomach ulcers and gastrointestinal bleeding has been the most common serious side effect from taking NSAIDs and aspirin. NSAIDs also increase the risk of heart attack and stroke.