As a doctor, I’ve often observed a worrying trend when visiting pharmacies in Sri Lanka. Just the other day, while standing in a queue at a local pharmacy, I noticed people purchasing numerous medications without a doctor’s prescription. What’s even more concerning is that these medications—ranging from antibiotics to painkillers—are handed out freely, without proper guidance or medical advice. It’s almost become routine for people to treat the pharmacy like a grocery store, stocking up on serious drugs without understanding the risks.
This habit of self-medicating is dangerous, especially with commonly used drugs like diclofenac and aspirin, both of which are widely available in Sri Lanka and often taken without considering their long-term consequences. Let me share why this can be harmful using an example I’ve seen far too often in my practice: the “Triple Whammy” effect.
The Dangers of Diclofenac, Aspirin, and Other NSAIDs
Diclofenac is one of the most widely used NSAIDs (non-steroidal anti-inflammatory drugs) in Sri Lanka. It’s commonly taken to relieve pain from arthritis, muscle aches, or injuries. While diclofenac can be effective for short-term pain relief, many people aren’t aware that frequent use can severely damage the kidneys. When taken with other medications like ACE inhibitors (blood pressure medications) and diuretics (water pills), it increases the risk of acute kidney injury or even kidney failure over time.
Aspirin, another NSAID, is commonly used for pain relief but is also widely prescribed in low doses to prevent heart attacks and strokes. While it can be beneficial in controlled, low doses under medical supervision, aspirin carries similar risks when misused or combined with other medications.
The “Triple Whammy” Risk
One of the most dangerous combinations people take unknowingly is the mix of ACE inhibitors (blood pressure medications), diuretics (water pills), and NSAIDs like diclofenac or aspirin. When taken together, these three drugs can seriously harm your kidneys, leading to acute kidney injury or even kidney failure over time. Here’s how it happens:
- ACE inhibitors and ARBs (commonly prescribed for blood pressure and heart conditions) relax blood vessels, reducing blood flow to the kidneys.
- Diuretics, often taken to manage high blood pressure or fluid retention, reduce blood volume and also decrease kidney blood flow.
- NSAIDs, like diclofenac or aspirin, block chemicals (prostaglandins) that help maintain blood flow to the kidneys.
When these medications are combined, they cause a “Triple Whammy” effect on the kidneys, drastically reducing their function. The result? Over time, your kidneys struggle to filter waste from your blood, leading to kidney damage or failure.
Why Relying on the Pharmacy Can Be Dangerous
Pharmacists play a crucial role in dispensing medication, but they are not doctors. They cannot diagnose your condition or understand your entire health profile without a detailed medical history. Self-medicating without a doctor’s guidance can lead to unintended drug interactions, as many of these medications affect different systems in the body—especially the kidneys.
In Sri Lanka, where access to medication is relatively easy, many people don’t realize how dangerous it is to take medications without knowing the full picture. Repeatedly buying painkillers like diclofenac or aspirin for headaches, muscle pain, or other issues, without considering their long-term effects, can slowly damage your body. The kidneys are one of the first organs to suffer.
The Reality of Kidney Failure
Kidney failure doesn’t happen overnight. It develops slowly, often with no obvious symptoms in the beginning. But by the time you start feeling weak, having swelling in your legs, or noticing changes in urination, the damage may already be severe. At this point, you may need dialysis or even a kidney transplant to survive. Sadly, in Sri Lanka, many people don’t realize the risks until it’s too late.
Take-Home Message: Always Consult a Doctor
I can’t stress this enough: medications aren’t harmless. They are powerful tools that need to be carefully managed and monitored by a healthcare professional. The pharmacist may mean well by giving you medication, but without a doctor’s evaluation, you could be walking down a dangerous path, especially when it comes to life-saving organs like your kidneys.
Please, always consult a doctor before taking any medication—whether it’s diclofenac, aspirin, or other common drugs. The damage caused by self-medicating might be invisible at first, but the consequences could be lifelong, especially for your kidneys. Let’s break the habit of taking medication casually and prioritize our long-term health.