There are two types of pain killers. One group of painkillers that reduce inflammation are called nonsteroidal anti-inflammatory drugs (NSAID). The other group just relieves the pain without reducing inflammation. These drugs are derivatives morphine and related compounds.
Examples of commonly used drugs of both groups are given below
NSAID
Generic name Trade name
Ibuprofen- Brufen
Diclofenac- Voveran
Piroxicam- Pirox
Nimuselide- Orthobid
Other pain killers
Generic name Trade name
Tramadol- Tramzac
Dextropropoxefene- Proxyvon+ Paracetamol
What are the complications of NSAID use?
Prolonged use of NSAID can cause kidney damage. This condition is characterized by progressive kidney failure. High blood pressure and anemia are commonly seen with moderate to advanced disease. Prolonged intake of any of the NSAID will result in this condition. Till recently paracetamol was considered to be safe, however recent studies have shown that chronic use of pracetamol also can cause kidney disease.
Administration of a single dose of NSAID also can cause kidney failure in susceptible individuals.
Risk factors for this condition include the following:
Old age
Dehydration
Liver disease
Mild kidney disease
Heart failure
High uric acid levels

Generally this condition resolves once the drug is stopped but may result in permanent kidney failure in some people.

Swelling of the body s a result of salt and water retention can occur in some patients
In some patients who have high blood pressure, control may become difficult.
Potassium level in the blood can increase.
Are there any safe pain- killers?
Painkillers, which do not belong to the NSAID group are safe. A list of commonly used drug is given below.
1. Tramzac _ tramadol
2. Proxyvon
Are Cox-2 inhibitors safe in patients with renal disease?
This is a class of NSAID, which does not cause irritation of the stomach. However, these drugs are as unsafe as other types of NSAID in patients with renal disease.
Example: Valdecoxib, Rofecoxib, Celecoxib
General guidelines regarding NSAID use.
Prolonged use of NSAID should be avoided.
Use of NSAID should be avoided or restricted in high- risk individuals.
Kidney functions should be periodically monitored in high-risk individuals receiving NSAID.