The Hidden Price of Pain Relief: The OTC Meds That Could Be Harming You

Most of us have a bottle of ibuprofen in the bathroom, acetaminophen in our desk drawer, or maybe some naproxen in the pocket of our gym bag. We casually take one (or three) whenever our back hurts, we get a headache, or our joints are aching.

And why not? They’re over the counter, right? They’re sold in bulk at most retailers, they must be safe… right? I see so many people buying the same exact medication (active ingredient) for back aches, headaches, joint pains, even in combination in a variety of sleep aids. Honestly, for a consumer who’s not comfortable reading the fine print and understanding what exactly they’re reading, that’s downright dangerous.

Pain Relief’s Dirty Little Secret

As your friendly neighborhood pharmacist, I’m here to spill some uncomfortable tea: just because it’s over the counter doesn’t mean it’s harmless.

People often think that if a medication doesn’t require a prescription, it’s safe to take without a second thought. But here’s the thing, medications like ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol) aren’t candy - they’re drugs with real consequences. And your kidneys and liver? They’re taking the hit, sometimes slowly, sometimes rather quickly. The elderly and those with diabetes, or those with certain blood disorders, liver, or kidney disease are especially at high risk.

Acetaminophen: Your Liver’s Frenemy

Let’s talk Tylenol. Good old acetaminophen. Works great for headaches, fevers, and pretending you’re fine after a late night out. But your liver? It hates when you overdo it.

Acetaminophen overdose is actually the #1 cause of acute liver failure in the U.S. That’s not some rare, exotic side effect – it’s common, and often unintentional, and you don’t need to down half a bottle for it to happen. You just have to:

• Take the max dose every day for too long
• Mix it with alcohol (even “just one glass of wine”)
• Or take multiple cold meds that also contain acetaminophen without realizing it (like NyQuil, DayQuil, Theraflu, etc.)

Before you know it, your liver’s being damaged.

 NSAIDs: Great for Pain and inflammation, Terrible for your Kidneys

Now let’s talk about NSAIDs like ibuprofen and naproxen. People take them for everything: workouts, period cramps, hangovers, you name it. And while they are effective, they can quietly wreak havoc on your kidneys, stomach, and blood pressure, especially if:

• You’re taking them daily
• You’re dehydrated (think the elderly, or even athletes!)
• You’re over 65
• You’re on blood pressure meds or diuretics
• Or you’ve got any kidney risk factors (even mild)

Here’s the kicker: people don’t feel kidney damage happening. It doesn’t burn, throb, or make a dramatic appearance. It just… sneaks up. Until one day your doc says, “Your kidney function’s down,” and you’re like, “Huh? But I only took Advil!” This happens so often, it’s truly heartbreaking. One of my close family members was hospitalized due to kidney failure after taking a combination of medications for back pain.

Worst of All…as if it can get any worse!

Ready for the most dangerous combination? Mixing ibuprofen with alcohol and intense exercise – your kidneys’ worst nightmare.

• Ibuprofen constricts blood flow to the kidneys
• Alcohol dehydrates you
• Exercise dehydrates you even more
• And guess who gets or what suffers the most? Your poor kidneys.

So yeah, if you're doing all that and wondering why you’re suddenly exhausted, bloated, or not peeing like you used to… it might not be “just age.” Speaking of age, kidney function declines with age even under the best of circumstances. Kidneys, it’s important to note, do not regenerate or repair themselves like the liver does.  This is as serious as it can get. 

Some Ideas or Suggestions.

I’m not telling you to throw away your Advil. Pain relief is important. But here’s what I am suggesting:

• Don’t double dip: check your meds for duplicate ingredients, if you’re not sure check with your doctor or your pharmacist.
• Respect the dose and don’t exceed it, even “just this once”
• Don’t take painkillers daily unless a doctor told you to do so
• Stay hydrated if you take NSAIDs
• Avoid mixing with alcohol
• Ask your pharmacist before adding new OTC meds to your routine

Final Thoughts from Behind the Counter

I don’t want to be the fun police or the “all drugs are bad for you” pharmacist.  I’ve taken ibuprofen for a headache and Tylenol for a fever just like you. But I’ve also seen people wind up with unexplained fatigue, or labs showing liver or kidney damage, all because they didn’t realize how quietly these meds can cause chaos.

So, treat your liver and kidneys like the vital organs they are. Be smart. Be curious. And don’t wash down that acetaminophen or ibuprofen with alcoholic beverages.  Even with taking every precaution there is, these drugs can be dangerous for certain groups of people. Remember, always get guidance from our healthcare provider before starting or changing any medications.

Till next time, take care of yourself and your insides.

~ Pharmacist Eddie

P.S. Got questions? Don’t hesitate to access our free Pharmacy Forum!