Assessment of Gastrointestinal and Renal Side Effects Associated with Long-Term Use of Over-the-Counter Painkiller Tablets. A Cross-Sectional Clinical Study: Gastrointestinal and Renal Toxicity of Long-Term OTC Analgesics

Mubashir Latif  Malik; Hamza Ihsan; Muhammad Hussain

doi:10.69750/dmls.02.011.0171

Authors

Mubashir Latif Malik Family Medical Specialist, Umeed Hospital, Chakwal, Pakistan Author
Hamza Ihsan Postgraduate Resident (PGR), Department of Urology, Dr Faisal Masood Teaching Hospital, Sargodha, Pakistan Author
Muhammad Hussain Postgraduate Resident (PGR), Department of Orthopedics, Itefaq Trust Hospital, Lahore, Pakistan Author

DOI:

https://doi.org/10.69750/dmls.02.011.0171

Keywords:

Analgesics, NSAIDs, Gastrointestinal, Renal, Toxicity, Self-medication, Overuse, Nephropathy, Ulceration, Screening

Abstract

Background: Over-the-counter (OTC) painkiller tablets are commonly used for self-medication without clinical supervision. Long-term or frequent use, particularly of non-steroidal anti-inflammatory drugs (NSAIDs), is associated with gastrointestinal (GI) and renal adverse effects. In populations with high rates of unsupervised medication use, understanding these risks is essential.

Objectives: To assess the prevalence of GI and renal side effects among adults using OTC painkillers for more than three months and to examine the relationship between analgesic use patterns and adverse outcomes.

Methods: A cross-sectional clinical study was conducted among 100 adults with OTC painkiller use exceeding three months. Structured interviews documented the type, duration, and frequency of analgesic intake. Clinical and laboratory assessments, including serum creatinine, blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urinalysis, and stool occult blood testing, were performed to detect adverse effects. Statistical analyses evaluated associations between analgesic use patterns and complications.

Results: Participants had a mean age of 38.6 ± 12.4 years, and 57% were female. Paracetamol was the most frequently used analgesic (62%), followed by ibuprofen (48%) and diclofenac (31%). GI symptoms occurred in 68% of users, with dyspepsia (42%) and abdominal pain (36%) being the most common. Renal abnormalities were observed in 34% of participants, including elevated serum creatinine (19%) and reduced eGFR (17%). Longer duration and higher frequency of use were significantly associated with both GI and renal complications (p < 0.05).

Conclusion: Long-term OTC painkiller use, especially NSAIDs, is strongly associated with gastrointestinal and renal adverse effects. Public education, responsible self-medication, and periodic clinical monitoring are essential to minimize preventable harm.

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References

Bakshi K, Tyagi R, Jaglan G, Rani P, Balkrishna A, Singh P, Varshney A. Preprint. medRxiv. 2025. doi:10.1101/2025.10.07.25337490.

Gülçiçek S. High prevalence of chronic musculoskeletal pain and analgesic use in geriatric patients with chronic kidney disease. Bagcilar Med Bull. 2023;8(3):248–258. doi:10.4274/BMB.galenos.2023.2023-07-062.

Shaqfeh MI, Alsayed AR, Hasoun LZ, Khader HA, Zihlif MA. Effects of trade names on misuse of OTC drugs and community knowledge in Alkarak, Jordan. Patient Prefer Adherence. 2024;18:2697–2708. doi:10.2147/PPA.S490277.

Ishrayhah M, Ishrayhah H, Abd-alhafid M, Abd-alhafid N. Assessing Community knowledge and use patterns of NSAIDs in Zawia City: a cross-sectional study. Libyan J Med Res. 2025;19(1):183–192. doi:10.54361/LJMR.191.1.27.

Bilder GE, Brown-O’Hara P. Over-the-counter medications, vitamins, minerals, biologicals, and herbal supplements. In: Drug Use in the Older Adult. Cham: Springer; 2025. doi:10.1007/978-3-031-84831-5_9.

Buda V, Prelipcean A, Cristescu C, Roja A, Dalleur O, Andor M, et al. Prescription habits in elderly patients with chronic diseases: practices and recommendations. Int J Environ Res Public Health. 2021;18:7043. doi:10.3390/ijerph18137043.

Ahmed A, Eldesouki S, Mirza DJ, et al. Knowledge, attitudes, and practices regarding analgesic use in adults in the UAE: a cross-sectional study. Cureus. 2025;17(9):e91522. doi:10.7759/cureus 91522.

Ben Saod AF, Eid Albhbah W. Practice and awareness of NSAID safety among dental practitioners: a cross-sectional study. Sci J Univ Benghazi. 2024;37(2):141–153. doi:10.37376/sjuob.v37i2.7125.

Heimes D, Holz NV, Pabst A, et al. Dental recommendations and prescribing patterns for systemic analgesics: a cross-sectional study. Clin Oral Investig. 2025;29:383. doi:10.1007/s00784-025-06403-4.

Sari DM, Rønne Pedersen J, Thorlund JB, Mikkelsen UR, Møller M. Pain medication use in youth athletes: a cross-sectional study. Transl Sports Med. 2021;4:914–920. doi:10.1002/tsm2.295.

Enstad F, Helseth S, Løyland B, Haraldstad K, Skarstein SO. Use of OTC analgesics in Norwegian children: a national cross-sectional study. Scand J Public Health. 2024;0:1–12. doi:10.1177/14034948251328492.

Alomaim LH, Alnefaie AF, Alowaymir NA, et al. Prevalence of self-medication among female university students during examinations in Saudi Arabia. Cureus. 2023;15(4):e37269. doi:10.7759/cureus 37269.

Moni S, Ayish F, Musawi S, Ravula SR, Abdelwahab SI, Salawi A, et al. Analgesic self-medication and its broad implications: a comprehensive review. Crit Public Health. 2025;35(1). doi:10.1080/09581596.2025.2582887.

Farah RI, Khatib AE, Abu Ziyad HJ, Jiad DK, Al Qusous LR, Ababneh AJ, et al. Use patterns and awareness of NSAID adverse effects in Jordan. Ann Med. 2023;55(2). doi:10.1080/07853890.2023.2242248.

Alharbi AO, Almjayishi SA, Aldarwish RI, et al. Knowledge and use of oral NSAIDs among patients with rheumatic disorders in Saudi Arabia. Cureus. 2023;15(11):e48500. doi:10.7759/cureus 48500.

Hessami A, Pourali A, Saeedi M, et al. Demographic and clinical characteristics of NSAID consumers: findings from the Tabari Cohort. BMC Public Health. 2025;25:2947. doi:10.1186/s12889-025-24005-3.

Alqudah M, Stubbs MA, Al-Masaeed M, Fernandez R. Parental preferences in managing childhood fever: experience with ibuprofen and paracetamol. J Pediatr Nurs. 2025;80:e272–e281. doi:10.1016/j.pedn.2024.12.018.

Algarni M, Hadi MA, Yahyouche A, et al. OTC medicine misuse, abuse, dependence, and risk-reduction interventions: a mixed-methods systematic review. J Pharm Policy Pract. 2021;14:76. doi:10.1186/s40545-021-00350-7.

Nisa M, Naseralallah L, Altarawneh L, et al. Prevalence of potentially inappropriate medications in diabetic nephropathy patients. Cureus. 2024;16(11):e74159. doi:10.7759/cureus 74159.

Abdelkader AM, Alhassan GT, Albukhaytan WB, Alnoubi EA, AlRasheedi WN, Alomran EA. Self-medication patterns and knowledge among undergraduate health sciences students. SAGE Open Nurs. 2025;11. doi:10.1177/23779608251330865.