Study Links Kidney Disease to Use of Painkiller

Long-term users of the banned painkiller phenacetin are 16 times more likely than others to die of urologic or kidney disease, according to a Swiss study that some researchers believe should prompt study of the popular analgesic, acetaminophen.

The study, published today in the New England Journal of Medicine, followed more than 1,000 Swiss women over 20 years. The long-term phenacetin users were more than twice as likely to die of a variety of causes, including cancer and cardiovascular disease.

Salicylates, such as aspirin, had no such effect.

Dr. Paul D. Stolley, a University of Pennsylvania professor of medicine who wrote an editorial accompanying the study in the journal, said the finding about phenacetin should prompt interest in the health effects of long-term use of acetaminophen.

“Since acetaminophen is an important metabolite of phenacetin, there is reason to regard bad news about phenacetin as having possibly distressing implications for acetaminophen as well,” Stolley wrote. In an interview, he said long-term studies are needed.

A controversial study of acetaminophen, the primary ingredient in Tylenol and other popular painkillers, published in May, 1989, concluded that people who took two or more tablets daily for at least a year had triple the normal risk of developing disabling kidney disease.

U.S. regulators ordered phenacetin off the market more than a decade ago because of concerns about its effects on the kidneys. It had been widely used as part of a preparation called ACP, made up of aspirin, phenacetin and caffeine.

Phenacetin remains in use in many other parts of the world.