Regular, long-term use of antacids, certain painkillers, and muscle relaxants without medical or pharmacist supervision may adversely affect liver and kidney function over time. Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce blood flow to the kidneys, increasing the risk of acute kidney injury and, in some cases, chronic kidney disease. High doses of paracetamol (acetaminophen) can cause liver damage, while certain muscle relaxants may also affect liver function. In addition, prolonged use of some types of antacids may interfere with the absorption of essential minerals or mask symptoms of underlying gastrointestinal conditions. Regular liver and kidney function assessments, together with individualized medication management, can help identify potential risks early and support long-term organ health. Always consult a doctor or pharmacist before using medication regularly or for extended periods.
The Habit of Relying on Symptom-Relief Medications in Thai Society
More than 60% of working-age adults in Thailand reportedly choose to self-medicate with painkillers for symptoms such as back pain, headaches, or stomach pain before seeking medical attention. Among this group, more than 30% are said to continue taking medication for over a month without a prescription. Thailand has an estimated 11.6 million people living with chronic kidney disease. In addition to diabetes and high blood pressure, inappropriate use of painkillers, herbal remedies, and combination medicines may contribute to kidney damage. Early-stage chronic kidney disease (Stages 1–3) often causes no noticeable symptoms, meaning many patients may not seek medical attention until significant kidney damage has occurred.
Note : The statistics provided, including the 60%, 30%, and 11.6 million figures, should be verified against reliable sources before publication.
How Do Different Medications Affect the Liver and Kidneys?
1. How Do NSAIDs and Muscle Relaxants Affect the Kidneys?
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, as well as certain combination pain medications containing muscle relaxants, may affect kidney function when used inappropriately.
How They Affect the Kidneys : NSAIDs inhibit the production of prostaglandins, substances that help maintain blood flow to the kidneys. In susceptible individuals, this can reduce kidney blood flow and lead to acute kidney injury. Prolonged or repeated use may also contribute to chronic kidney problems, particularly in people with existing kidney disease or other risk factors.
Potential Complications : NSAIDs may cause fluid and sodium retention, increase blood pressure, and raise the risk of stomach ulcers and gastrointestinal bleeding.
2. How Can Paracetamol and Muscle Relaxants Harm the Liver?
Paracetamol and Liver Damage : The liver metabolizes paracetamol (acetaminophen). Taking more than the recommended dose can cause a toxic metabolite called NAPQI to accumulate, damaging liver cells and potentially causing acute liver failure. The maximum recommended adult dose depends on individual circumstances and product instructions; taking more than 4,000 mg in 24 hours can cause serious harm. Some people require a lower maximum dose. Do not exceed the recommended dose or combine multiple products containing paracetamol.
Muscle Relaxants : Certain muscle relaxants can affect liver function. Combining some medications with alcohol may increase the risk of adverse effects. Always check the specific medication with a doctor or pharmacist before using it regularly.
3. Can Long-Term Use of Antacids Have Hidden Risks?
Masking Underlying Conditions : Regularly treating persistent stomach discomfort with antacids may delay the diagnosis of underlying conditions, such as peptic ulcers or other gastrointestinal diseases. Persistent or worsening symptoms should be medically evaluated.
Effects on Nutrient Absorption and Kidney Function : Long-term use of proton pump inhibitors (PPIs), a class of acid-reducing medication, has been associated with low levels of certain nutrients, including vitamin B12 and magnesium in some patients. PPIs have also been linked to acute interstitial nephritis, a form of kidney inflammation. The risk varies among individuals, and long-term treatment should be reviewed periodically with a healthcare professional.
Warning Signs : When Your Liver or Kidneys May Need Medical Attention
If you frequently use painkillers, muscle relaxants, or antacids and experience any of the following symptoms, seek medical evaluation.
Possible Kidney Problems : Unusually foamy urine, dark tea-colored urine, swelling of the feet, shins, or eyelids, or an unexplained increase in blood pressure.
Possible Liver Problems : Persistent fatigue, yellowing of the skin or eyes, nausea or vomiting, or discomfort in the upper-right abdomen.
Important: These symptoms do not necessarily indicate liver or kidney disease, and early kidney or liver damage may cause no noticeable symptoms. If you suspect you have taken too much paracetamol, seek urgent medical care even if you feel well. For ongoing medication use, consult a doctor or pharmacist to determine the appropriate dose, duration, and need for liver and kidney function tests.
Personalized Liver and Kidney Health Screening
Our hospital focuses on proactive preventive healthcare to help you use medications safely and protect your liver, kidneys, and overall health.
1. Comprehensive Liver and Kidney Function Screening
Kidney Function Tests : Blood tests, including Blood Urea Nitrogen (BUN) and creatinine, along with the estimated glomerular filtration rate (eGFR), help assess kidney function. Urine testing for albumin, including microalbuminuria screening when appropriate, may also be performed to detect early signs of kidney damage.
Liver Function Tests : Tests for liver enzymes, including AST, ALT, and ALP, as well as bilirubin levels, help assess liver function and identify possible signs of liver injury or abnormalities involving the liver and biliary system.
2. Clinical Pharmacy Services and Personalized Medication Management
Our pharmacists and specialist physicians work together to review your medication history and assess your current medication use. They can help document medication allergies and regular medications while providing personalized recommendations to promote safe and appropriate medication use. Depending on your condition, alternative approaches to symptom management, such as physical therapy and dietary modifications, may also be recommended to reduce unnecessary reliance on medication.
“Medication is not something to take lightly. Relieving pain temporarily through self-medication may carry risks to your liver and kidneys, especially when medications are used improperly or for prolonged periods.” Seeking medical evaluation to identify the underlying cause of persistent back pain, acid reflux, or other recurring symptoms allows for more appropriate treatment and helps reduce the risks associated with unnecessary medication use. Following medical advice is an important step toward protecting your internal organs and maintaining long-term health so you can continue enjoying quality time with your family.
Safe Medication Practices
Avoid prolonged self-medication : If pain, abdominal discomfort, or other symptoms persist or worsen, consult a physician or pharmacist to determine the cause and receive appropriate advice.
Read medication labels and avoid duplicate ingredients : Always check the active ingredients to prevent accidentally taking the same medication from multiple products.
Provide a complete medication history : Whenever you visit a physician or pharmacist, inform them of all medications, vitamins, herbal products, and dietary supplements you currently take.
Maintain adequate hydration : Drink sufficient water according to your individual needs. People with kidney or heart conditions, or those advised to restrict fluid intake, should follow their physician’s recommendations.
Preparing for Liver and Kidney Function Screening
Check fasting requirements before your appointment : Some tests, such as blood glucose testing, may require fasting for 8–12 hours. However, fasting requirements vary depending on the tests ordered. Please follow the hospital’s instructions before your appointment.
Bring your current medications : Bring your medication packages, labels, or a complete list of the medications you regularly take, including vitamins and herbal products, so your physician or pharmacist can review them and provide appropriate recommendations.
Thonburi Thawiwatthana Hospital is committed to providing holistic healthcare tailored to individual needs. Our care team includes physicians specializing in nephrology and liver diseases, as well as clinical pharmacists. Supported by a modern laboratory equipped for standardized diagnostic testing, we aim to help assess health risks, identify potential liver and kidney abnormalities at an early stage, and support safer medication management. Through individualized assessment and appropriate medical guidance, we strive to support the long-term health and well-being of you and your family.
