… Dr. Godwin Nwonu’s (GIN) Health Advise to Men
Men,
We have abused a lot of painkillers including, bruffen, paracetamol etc.
Painkillers are supposed to be used with extreme caution. Do you think it’s just an everyday painkiller? Think again.
One wrong move and your liver might not forgive you.
Pain killers should be used with extreme caution due to several critical risks, especially in vulnerable populations.
Why is this important?
- Risk of Liver Toxicity (Hepatotoxicity)
Painkillers are metabolized in the liver, and excessive doses can overwhelm its detoxification pathways, leading to severe liver damage or acute liver failure.
This risk is significantly higher in:
– Patients with hepatic impairment or active liver disease: The liver’s reduced ability to process painkiller increases toxicity risk.
– Chronic alcohol users: Alcohol weakens liver function and enhances toxicity.
– Patients taking enzyme-inducing drugs that speed up the formation of toxic metabolites. For example; Rifampicin, Phenytoin, Carbamazepine
- Narrow Therapeutic Index
The safe dose and toxic dose of painkillers are not far apart. If you exceed mostly 4 to 6 times a day this increases the risk of liver failure, making overdose a common concern.
- Hidden Presence in Other Medications painkiller ingredients are
found in many cold and flu medications, painkillers, and combination drugs. People may unknowingly take multiple products containing same synthetic ingredients, leading to accidental overdose.
- Kidney Damage (Nephrotoxicity)
Long-term high-dose use of painkillers is linked to chronic kidney disease (CKD), especially in people with pre-existing kidney problems.
- Use Caution in Patients with Chronic Malnutrition: Chronic malnutrition can reduce glutathione stores, an important antioxidant that helps detoxify painkillers toxic metabolites.
In malnourished patients, even therapeutic doses of painkillers can lead to liver toxicity due to reduced metabolic reserves.
- Drug Interactions
Alcohol: Increases liver toxicity risk.
Warfarin: Chronic painkiller use may enhance the anticoagulant effect, increasing bleeding risk.
- Delay in Recognizing Overdose Symptoms
Unlike some drugs that cause immediate distress when taken in overdose, painkillers overdose symptoms (nausea, vomiting, and abdominal pain) may be delayed and this can also delay treatment and increase the risk of irreversible liver damage.
- Special Populations at Higher Risk
-Children: More susceptible to dosing errors.
-Elderly patients: This is due to slower metabolism, and higher sensitivity to liver and kidney effects.
-Pregnant/Breastfeeding women: Generally safe in recommended doses, but long-term high doses should be avoided.
Painkillers especially NSAIDs are an effective pain reliever, but it must be used cautiously in patients with liver impairment, active liver disease, and chronic malnutrition. To avoid toxicity, patients should adhere to recommended doses. Stop abusing tablets for minor pain like headaches flue instead try to use natural home remedies.
GIN
