The Food and Drug Administration (FDA) requires that over-the-counter pain relievers must carry a warning label for people who consume three or more alcoholic drinks daily. The FDA requires the specific warnings concerning "liver damage" and "stomach bleeding,” stating that consumers with a history of chronic alcohol use need to know the potential risk that use of over-the-counter analgesic drugs may pose.

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But even those who do not consume alcohol are at risk for liver damage. Aspirin has been shown to cause liver abnormalities at low-doses (250 mg/day).

People with hepatitis C are especially prone to liver damage caused by taking common pain relievers. According to a study by Dr. Thomas Riley III, head of the liver transplant program at the Milton S. Hershey Medical Center of Penn State Geisinger Health Center, even low-dose ibuprofen can cause liver damage in patients with hepatitis C. (American Journal of Gastroenterology, Sept. 98 and Journal of the American Medical Association Oct. 98)

According to this study, patients with chronic hepatitis C experience a 10-fold rise in their enzymes after taking ibuprofen, suggesting significant liver injury and Hepatitis C patients risks speeding up the process of going from chronic hepatitis to cirrhosis of the liver.

The liver is an organ located on the right side of the body underneath the lower rib cage. Among other valuable services to the body and to health, the liver plays a large role in protecting the body from harmful substances. The liver filters blood of bacteria and poisons and breaks down alcohol and drugs. Drugs are defined as legal and illegal, prescription and over-the-counter.

The liver generally does a good job of filtering these toxins out of the body but can become scarred and diseased if overloaded for an extended amount of time. One or two glasses of wine mixed with four ibuprofen tablets is all it takes to develop liver damage.

The liver, when taxed beyond its ability to filter toxins, can develop fibrous tissue, which can develop then into scar tissue. A person may unknowingly have liver damage for years before there is a danger of liver failure or liver cancer developing.

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Like the liver, the kidneys act as filters to clean the blood. The kidneys rid the body of waste and excess fluid. And like the liver, the kidneys can also become irreversibly damaged by the use of NSAIDs like ibuprofen.

“Analgesic nephropathy” is a chronic kidney disease caused by prolonged use of analgesics like aspirin and ibuprofen. This kidney disease gradually leads to end-stage renal disease and the permanent need for dialysis or a kidney transplant to restore renal function.

Painkillers that combine two or more analgesics with caffeine or codeine are most likely to cause damage to the kidneys. Read your labels carefully. Though not widely publicized, the pain relievers Anacin and Excedrin contain up to 120 milligrams of caffeine. A regular cup of coffee contains about 85 milligrams of caffeine.

People with chronic kidney conditions, advanced age, systemic lupus and those who binge drink may be more susceptible to kidney failure from the use of painkillers.

People who take painkillers on a regular basis should check with their doctors to make sure they are not hurting their kidneys or their liver.

When considering whether to take these common OTC pain relievers, as with most chemicals, the safest route is to avoid these drugs. If taken, over-the-counter pain relievers should never be combined with alcohol and they should be taken at or below the dose recommended on the label.

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