Risks Associated With Over-the-Counter Painkillers

Any over-the-counter drug can have a side effect, so deciding to buy and use these drugs becomes an exercise in weighing the likely benefits against the potential costs, medical experts say.

Here are some reactions to watch out for with common over-the-counter painkillers:

ASPIRIN

USES: Reduces fever, relieves pain, eases arthritis and in small doses can prevent blood clots.

SIDE EFFECTS: Can cause stomach irritation, even bleeding. Asthmatics may suffer an attack if they take aspirin. Extended use is associated with a twofold increase in renal cancer. In large doses, such as for arthritis, can affect liver function, but reversibly. In children and teen-agers with viral illnesses, can trigger potentially fatal Reyes syndrome, so is not recommended for use in flu-like illnesses in children.

In January, doctors reported a case of an elderly patient on long-term aspirin therapy for arthritis who died after she was inadvertently given a double dosage of the drug for 10 days. They suggest that, if a person is already taking high doses, even small increases in that dose could be dangerous.

ACETAMINOPHEN

USES: Used for pain and fever, especially since it is less likely to irritate the stomach than aspirin.

SIDE EFFECTS: A recent study found it caused digestive discomfort in some people. Extended use is associated with a twofold increase in renal cancer, and with a threefold increase in the risk of kidney damage (reversible if recognized early). Can cause severe liver damage in large doses, so even overdoses that cause no immediate symptoms need prompt medical treatment. Alcohol consumption increases the chance of liver damage from this drug.

There have been two reported cases in the United States of children dying after their parents greatly increased their acetaminophen doses to try to make them better, according to a May 1988 study in the journal Clinical Pharmacy.

IBUPROFEN

USES: Relieves mild pain, eases arthritis and other inflammatory conditions. Less likely to cause stomach bleeding and impaired liver function than aspirin.

SIDE EFFECTS: Can cause stomach irritation, nausea or, rarely, stomach bleeding. Asthmatics sensitive to aspirin also may suffer an attack if they take ibuprofen. Dizziness, headache and rash also can occur. Some doctors blame extended consumption of ibuprofen for kidney damage (reversible if recognized early).