Too Much Pain Medicine

Pain medication can be a good thing. From a small headache to a major injury, pain medications assist us in coping with the less pleasant aspects of life. They allow people to recover from various ailments much better, and keep people in more positive frames of mind when they do not have to deal with what could otherwise be agonizing pain following surgery or major accidents. To repeat the cliché however, too much of a good thing can be harmful.

Pain medications generally work by acting on the body’s peripheral and central nervous systems, to block or decrease sensitivity to pain, while some types work by inhibiting the formation of certain chemicals in the body. Pain relievers fall generally into four categories. They are, acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), opioids and non-opioids.

The first acetaminophen and NSAIDs are generally over-the-counter offerings, while opioids and non-opioids are prescription medications. All of these medications have their own particular risks, but I wanted to discuss the risks associated with NSAIDs. When used improperly, NSAIDs can cause kidney damage, and the risk increases for those over 60 years of age who are taking a diuretic, have high blood pressure or heart disease, or pre-existing kidney disease. Also, When taken regularly, NSAIDs may cause kidney damage.

The Role of the Kidney

The kidney’s role in the body is to act as “the body’s natural filtration system, removing waste products and fluids from the bloodstream.” Damage (depending on the extent) to the kidney is very dire, because the kidney loses its ability to “filter waste and fluids from the blood.” This is important because the kidneys also “maintain the body’s salt and water balance, which is important for regulating blood pressure.” When damaged, the kidneys lose this ability, causing fluid and waste buildup in the body, which in turn, can cause many complications. Many times, other systems of the body are adversely affected, including the “respiratory, circulatory, and digestive systems.”

Among the numerous causes of kidney malfunction, certain medications, like the ones discussed above, can cause kidney damage. Here is a list of common NSAIDs.

Traditional NSAIDs

• Diclofenac (brand names: Cataflam, Voltaren)
• Etodolac (brand name: Lodine)
• Fenoprofen (brand name: Nalfon)
• Flurbiprofen (brand name: Ansaid)
• Ibuprofen (2 brand name: Advil, Motrin)
• Indomethacin (brand name: Indocin)
• Ketoprofen (brand names: Orudis, Oruvail)
• Meclofenamate
• Meloxicam (brand name: Mobic)
• Nabumetone (brand name: Relafen)
• Naproxen (brand names: Anaprox, Naprelan, Naprosyn)
• Oxaprozin (brand name: Daypro)
• Piroxicam (brand name: Feldene)
• Sulindac (brand name: Clinoril)
• Tolmetin (brand name: Tolectin)

COX-2 inhibitors

• Celecoxib (brand name: Celebrex)

These drugs are powerful. In fact, it is suggested that anyone needing to take even an over-the-counter pain medication for longer than a week “should discuss this risk and explore other treatment options with their family doctor.”

Look for my next post on how and why pain medications affect kidney function. However, in the mean time, if you find yourself making regular use of pain medications, you should probably discuss this with your doctor.