The Painkillers You Pop Can Cause Acute Liver Failure If Taken Recklessly
April 19 marks World Liver Day, a global reminder to care for one of the body’s most hardworking organs. The theme for 2025, “Food is Medicine”, highlights the vital role nutrition plays in liver health. But beyond the plate, another lesser-known but growing threat is silently stressing livers across India — the casual and excessive use of painkillers.
According to health experts, the liver faces a toxic overload when people take a lot of painkillers — worse, if along with multiple medications — at once. What compounds the problem is that fact that liver damage can be silent in its early stages, making detection difficult.
Dr Giriraj Bora, Chief, Liver Transplant and Senior Consultant - GI & HPB Surgery, at Artemis Hospitals, shares with ABP Live concerns over this emerging health concern of people casually popping painkillers.
"The liver helps break down substances we consume, including medicines," Dr. Bora explains. "When we take painkillers too often or in large amounts, we unknowingly put our liver under stress. This habit, especially common in India due to easy over-the-counter availability, can lead to long-term liver damage."
Why This Is A Serious Concern
The liver metabolises most drugs, including common over-the-counter painkillers like paracetamol and ibuprofen. Taking these medications frequently or in high doses can overload liver enzymes, eventually causing inflammation, toxicity, or even liver failure in extreme cases.
What makes the issue more dangerous is how silent liver damage can be in its early stages.
"The liver doesn’t give early warning signs,” says Dr Bora. “You may feel completely normal while damage progresses quietly. Symptoms like yellowing of the eyes or chronic fatigue often appear only after significant harm has been done.”
This reality is especially concerning in India, where a culture of self-medication prevails. Painkillers are often bought for routine headaches, body aches, and fevers — no questions asked.
"In most Indian pharmacies, people can easily buy painkillers without a prescription. This encourages casual consumption, even for minor discomforts,” Dr Bora notes. “The real problem begins when this becomes a habit, or when medicines are taken without proper dosage awareness.”
Multiple Medicines, One Overworked Liver
The risk escalates further when people take multiple medications at once — say for a cold, fever, and a headache. Many such pills contain acetaminophen (paracetamol) or similar compounds. When taken together or unknowingly combined with other drugs, the liver faces a toxic overload.
"Some drug combinations are poisonous, especially when they include painkillers,” says Dr. Bora. “They make the liver weaker, slower, and more vulnerable.”
This has been supported by international research as well. A 2022 study by Johns Hopkins University School of Medicine found that excessive use of acetaminophen is one of the leading causes of acute liver failure in developed countries. The situation is worse in regions where medication is more freely available without clinical guidance. Additionally, Johns Hopkins Medicine website also highlighted that acute liver failure is a rare condition. It happens when your liver suddenly refuses to work. This often happens right after an overdose of medicine or poisoning. Chronic liver failure happens over a long stretch of time.
When Pain Doesn’t Need A Pill
So, what’s the alternative?
Not all pain needs medication, says Dr Giriraj Bora.
“Sometimes, simply drinking water, resting, or stretching will work,” he says. “It’s always safer to see a doctor if the pain doesn’t go away, rather than taking medicines repeatedly without knowing their long-term impact.”
The American Liver Foundation website emphasises the importance of reading medicine labels, avoiding multiple medications containing acetaminophen simultaneously, and consulting healthcare providers about dosing, it does not specify a maximum daily dosage limit. However, it highlights that exceeding the recommended dose can lead to liver damage and that acetaminophen overdose is a leading cause of acute liver failure in the United States.
Four Steps To Follow For Safe Consumption Of Acetaminophen
- Always read and follow the medicine label
- Know if your medicines contain acetaminophen
- Never take two medicines with acetaminophen at the same time
- Ask your healthcare provider or pharmacist if you have questions about dosing instructions or medicines that contain acetaminophen.
A Wake-Up Call On World Liver Day
Liver health is not just about food — it's also about medicine. The 2025 theme, “Food is Medicine”, emphasises that what we consume has powerful effects on liver function, for better or worse.
And while focusing on liver-friendly foods like fruits, vegetables, legumes, and healthy fats is crucial, so is re-evaluating our approach to painkillers and self-medication.
"Your liver is your body’s detox centre. Don’t overwhelm it,” says Dr. Bora. “A healthy liver doesn’t just support digestion—it supports life.”
The writer is a senior independent journalist.
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]
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