Safe Painkiller Use: New CDSCO Advisory on Kidney Health

In short: The CDSCO issued an advisory on 21 September 2026 cautioning that unsupervised use of NSAIDs can contribute to chronic kidney disease. Painkillers are prescription medicines and should not be taken repeatedly without medical advice.

On 21 September 2026 the Central Drugs Standard Control Organisation (CDSCO) issued an advisory addressed to healthcare professionals, pharmacies and the public, warning that the indiscriminate and prolonged use of painkillers—particularly non-steroidal anti-inflammatory drugs (NSAIDs)—can cause kidney damage and contribute to chronic kidney disease. The circular arrived against a sobering backdrop: an estimated 138 million Indians are already living with chronic kidney disease, and a significant share of kidney dysfunction cases are now linked to frequent painkiller use without medical supervision.

What the Advisory Says

The advisory reiterates that most NSAIDs—the class that includes ibuprofen (Brufen, Advil), diclofenac (Voveran), naproxen and others—are listed under Schedule H of the Drugs Rules, 1945, meaning they are prescription medicines and must not be sold by retail without a prescription from a registered medical practitioner. The CDSCO warns that excessive or inappropriate consumption of NSAIDs can cause kidney damage and worsen chronic kidney disease. The advisory calls for rational and responsible use: NSAIDs should be used only when clinically indicated, at the appropriate dose, for the appropriate duration, and under medical supervision.

Medical data suggest that 10 to 15 per cent of renal dysfunction cases are now linked to frequent painkiller use. The condition where long-term use of painkillers causes kidney damage is known as analgesic nephropathy. Unlike other organs, kidneys do not signal distress with pain; significant kidney function can be lost before symptoms appear, which is why the habit of reaching for a painkiller at the first sign of discomfort is more consequential than many people realise.

How NSAIDs Affect the Kidneys

NSAIDs work by blocking cyclooxygenase (COX) enzymes, which reduces inflammation and pain but also blocks the production of prostaglandins—substances that help keep blood vessels in the kidneys open and maintain normal blood flow. Without adequate prostaglandins, blood flow to the kidneys can be reduced, and over time this can lead to ischaemia, tissue damage and impaired kidney function. When NSAIDs are taken during periods of dehydration, illness or by people with pre-existing health conditions such as hypertension, diabetes or heart disease, the risk of acute kidney injury increases sharply.

Long-term or frequent NSAID use is associated with a condition called renal papillary necrosis, where parts of the kidney tissue die, and chronic interstitial nephritis, an inflammation between the kidney's filtering tubules. Both lead to progressive loss of kidney function. The damage is often silent, discovered only during routine blood or urine tests, by which time a significant proportion of kidney capacity may already be compromised.

Who Is Most at Risk

Certain groups are far more vulnerable to NSAID-related kidney damage. People with existing kidney disease, even if mild, have kidneys that are less able to compensate for reduced blood flow. Those with diabetes or high blood pressure already have compromised kidney function due to vascular changes. Older adults—particularly those over 65—face higher risks because kidney function naturally declines with age. Dehydration is another major risk factor: when the body is already short of fluids, NSAIDs further restrict kidney blood flow, and acute kidney injury can develop within hours.

People taking diuretics (water tablets), ACE inhibitors, or angiotensin receptor blockers for blood pressure are at additional risk if they add an NSAID into the mix—this combination is sometimes referred to as the "triple whammy" because all three drug classes affect kidney blood flow and sodium balance in ways that compound the risk. Anyone in these categories should inform their doctor before taking a painkiller, even an over-the-counter one.

What the Public Should Do

The advisory asks the public to avoid self-medication with painkillers and not to use them repeatedly or for prolonged periods without advice from a doctor. If you have a fever, headache, body ache or joint pain that persists or recurs, the appropriate step is to see a doctor rather than continuing to take painkillers on your own. Over-the-counter availability does not mean a medicine is without risk—NSAIDs are potent drugs with real consequences when used incorrectly.

If you already have diabetes, high blood pressure, heart disease or any degree of kidney impairment, or if you take blood pressure medicines or diuretics, you should make your doctor or pharmacist aware of that before taking any painkiller. For short-term pain or fever in people without kidney risk factors, paracetamol is generally safer than NSAIDs, as it does not interfere with kidney blood flow in the same way. However, even paracetamol should not be taken in excess or for extended periods without medical advice.

Get Your Medicines at Gautam Chemist, Sector 16, Panchkula

Gautam Chemist stocks paracetamol, NSAIDs and all commonly prescribed pain and fever medicines at discounts of 20 to 65 per cent off MRP. Our pharmacist is available to answer your questions, explain the appropriate use of any medicine, and remind you when a prescription is required. If you are managing diabetes, blood pressure or kidney disease and need guidance on which pain relief is safest for you, we are here to help. Visit us at SCO No. 195, Ground Floor, Sector-16, Panchkula.

Please note: this article is general information from a pharmacy, not medical advice. Medicines, doses and timings must be decided by your doctor. Never start, stop or change a medicine on your own.