Is Excessive Painkiller Use Harmful to Your Liver and Kidneys?

Using a lot of painkillers can lead to several potential issues. Overuse of nonsteroidal anti-inflammatory drugs (NSAIDs) may cause gastrointestinal problems, such as ulcers or bleeding, as well as kidney damage. Opioids, on the other hand, can lead to dependence, tolerance, and an increased risk

Dr.
Hsu: I have another question to ask you.
I have been experiencing menstrual pain for a long time, with varying severity.
This time it was quite severe.
On the first day of my period, I took Poston for pain relief four times.
The pain worsened on the second day, and Poston was ineffective.
I went to the obstetrics and gynecology department and received an injection; first, I was given scopolamine, but it didn't work well, so I received another injection of ketorolac, along with one acetaminophen and one buprenorphine, which finally provided some relief.
The doctor also prescribed acetaminophen, piclofenac, loratadine, and buprenorphine for me to take home.
That night, after the pain relief injection wore off, the abdominal pain became unbearable, and the oral medications were not very effective.
On the morning of the third day, I rushed back to the obstetrics and gynecology department for another injection.
The first injection was ketorolac, but I still felt a lot of pain afterward.
The gynecologist suggested an ultrasound, and the results showed that my uterus and ovaries were normal, but there was some stretching of the ligaments, possibly indicating a bladder infection.
I was then advised to receive an IV drip that contained pain medication along with an anti-inflammatory injection, the components of which I am not sure about.
Additionally, at home, besides the medications prescribed the day before, I was given Perry.
My family and I are very concerned about using so many pain medications.
Could this harm my liver or kidneys? After each ketorolac injection, I experience bloating in my stomach.
I really don't know what to do.
Will using so many pain medications have significant effects?

Youxin Girl, 10~19 year old female. Ask Date: 2006/07/09

Dr. Xu Li'an reply Family Medicine

Dear worried girl Linda,
For menstrual pain, Panadol (Acetaminophen) is usually not very effective.
It is better to use Ponstan (Mefenamic Acid) for pain relief and cramping.
Brufen or Purfen (Ibuprofen) can also be effective.
Ketorolac and Diclofenac are also options.
For cramping, Buscopan (Scopolamine) can be used, available in both injectable and oral forms.
Perry is used for urinary tract infections caused by gynecological conditions.
If you need to take pain medication for three to seven days each month due to menstrual pain, it is acceptable and sometimes necessary.
Please do not add to your psychological stress.
Wishing you a speedy relief from pain.
Best regards,
Hua Medical Center
Dr.
Hsu Li-An
ID: 9507101112

Reply Date: 2006/07/09

More Info

Excessive use of painkillers can indeed pose significant risks to both the liver and kidneys, particularly when these medications are used frequently or in high doses. In your case, it appears that you have been using a combination of medications, including acetaminophen (commonly known as Tylenol), ketorolac (often referred to as "keto"), and other pain relief medications. Each of these has its own profile of potential side effects and risks, especially when used in conjunction with one another.

Liver Concerns
Acetaminophen is one of the most widely used pain relievers, but it is also known for its potential hepatotoxicity (liver toxicity). When taken in recommended doses, acetaminophen is generally safe; however, exceeding the recommended dosage can lead to severe liver damage. The risk is particularly heightened in individuals who consume alcohol regularly or have pre-existing liver conditions. It's crucial to monitor your total daily intake of acetaminophen, especially if you are taking it alongside other medications that may also affect the liver.

Kidney Concerns
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and ketorolac, can also have adverse effects on kidney function, particularly when used excessively. These medications can reduce blood flow to the kidneys and impair their ability to filter waste from the blood. In individuals with pre-existing kidney issues or those who are dehydrated, the risk of kidney damage increases significantly. It’s important to stay well-hydrated and to use these medications only as directed by a healthcare professional.

Combination of Medications
The combination of multiple painkillers can complicate the risk profile. For example, using both acetaminophen and NSAIDs can increase the likelihood of side effects, including gastrointestinal issues, liver damage, and kidney impairment. Additionally, medications like scopolamine and buwecon may have their own side effects and interactions that could further complicate your situation.

Recommendations
1. Consult Your Healthcare Provider: Given your extensive use of pain medications, it is essential to discuss your situation with your healthcare provider. They can evaluate your overall health, including liver and kidney function, and help you determine the safest pain management strategy.

2. Monitor Symptoms: Pay attention to any new symptoms that may arise, such as jaundice (yellowing of the skin or eyes), dark urine, abdominal pain, or changes in urination. These could indicate potential liver or kidney issues.

3. Limit Use of Painkillers: If possible, try to limit the use of painkillers to the lowest effective dose for the shortest duration necessary. Consider non-pharmacological approaches to pain management, such as physical therapy, heat application, or relaxation techniques.

4. Regular Check-ups: If you are using pain medications regularly, it may be wise to have regular check-ups that include liver and kidney function tests to monitor for any potential damage.

5. Educate Yourself: Understanding the medications you are taking, including their potential side effects and interactions, can empower you to make informed decisions about your health.

In summary, while pain management is crucial, it is equally important to be aware of the potential risks associated with excessive use of painkillers. By working closely with your healthcare provider and monitoring your health, you can find a balance that effectively manages your pain while minimizing the risk of harm to your liver and kidneys.

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