Long term use of Paracetamol and NSAIDs

Over-the-counter pain killers are best used for short term treatment.


A review of previous observational studies found that long-term use of paracetamol was linked with a small increased risk of adverse events such as heart attacks, gastrointestinal bleeds (bleeding inside the digestive system) and impaired kidney function.

The study was carried out by researchers from the Maudsley Hospital, London; University of Leeds; Newcastle University; Keele University; and other UK institutions. The review was undertaken by the National Clinical Guidelines Centre, UK, and the authors report no conflict of interest.

The study was published in the peer-reviewed Annals of the Rheumatic Diseases, a British Medical Journal, on an open-access basis, so it is free to read online or download as a PDF.

Paracetamol is an effective treatment for mild to moderate pain and fever in adults and children, when used as directed in product information. The maximum dose within a 24-hour period must never be exceeded. Even taking one or two more tablets than recommended can cause serious liver damage and possibly death. Paracetamol overdose is one of the leading causes of liver failure.

If you find you need to use paracetamol on a regular basis it is worth consulting your GP or physiotherapist. There may be more effective treatment options available.


Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen is associated with a number of negative consequences.

The most common medical problem arising from chronic NSAID use is gastritis, or inflammation of the lining of the stomach. NSAIDs decrease the body’s ability to create a natural protective layer between the lining of the stomach and stomach acid. Without this protection gastric acid can damage the stomach and lead to pain and inflammation.

Another frequent effect of chronic heavy NSAID use is damage to the kidneys. NSAIDs can decrease blood flow to the kidneys and over time lead to loss of function. If you are using ibuprofen every day to help control headaches, paradoxically the medicine itself may actually be contributing to them through a process call medication overuse headache, which is one of the most common causes of daily headaches.

Liver disease, strokes, and heart disease have also been associated with NSAID use.

If this information raises concerns, you should talk with your primary care provider to have your pain evaluated and find other pain relief options.