Should the sale of analgesic mixtures and non-steroidal anti-inflammatory agents (NSAIDs) continue to be allowed as over-the-counter (OTC) medications?

Abstract

The excessive use of analgesics and non-steroidal antiinflammatory agents (NSAIDs) is strongly associated with an increased prevalence of chronic renal insufficiency, some cases requiring long term replacement therapy (dialysis/transplantation). Analgesic nephropathy (AN) is now a well defined entity characterized by papillary necrosis and/or chronic interstitial nephritis. The elderly are especially susceptible and more frequently use these medications. Although the overall incidence of AN is low considering the widespread usage and pain and suffering alleviated by their ready availability over-the-counter (OTC), the need, as public policy, to better protect our citizens by restricting free access to these drugs remains open to debate.