Analgesic Nephropathy

An analgesic is a medicine used to relieve pain. Over-the-counter analgesics (medicines bought without a prescription) include:

  • Aspirin.

  • Acetaminophen.

  • Ibuprofen.

  • Naproxen.

These drugs present no danger for most people when taken in the recommended dose. Some conditions make taking common pain killers dangerous for the kidneys. Taking 1 or a combination of these drugs regularly, over a long period of time, may increase the risk for kidney problems.


Analgesic use has been linked to 2 different forms of kidney damage.

  • Some reports have linked acute kidney failure to the use of over-the-counter pain killers. These cases involved a single dose in some instances. Generally, the short-term analgesic use was for no more than 10 days. Drugs in this study include:

  • Aspirin.

  • Ibuprofen.

  • Naproxen.

  • The patients in these reports had risk factors, such as:

  • Systemic lupus erythematosus.

  • Advanced age.

  • Chronic kidney disease.

  • Recent heavy alcohol use.

  • A second form of kidney damage can result from taking pain killers every day for several years. It gradually leads to kidney failure. This causes a permanent need for dialysis or a kidney transplant.

  • Daily use of 2 kinds of pain killers (particularly aspirin and acetaminophen together) with caffeine or codeine are most likely to damage the kidneys. These mixtures are often sold as powders or tablets.

  • Acute kidney failure requires emergency dialysis to clean the blood. Kidney damage is often reversible. Normal kidney function returns after the emergency is over and the analgesic use is stopped.


Patients with conditions that put them at risk for acute kidney failure should check with their caregivers before taking analgesic medicine. People who take over-the-counter pain killers on a regular basis should check with their caregiver. Your caregiver may be able to recommend a safer alternative.