The dangers of addiction to household painkillers may lead to serious health problems, an Australian study has warned.
The research has detailed the cases of 27 people addicted to codeine and ibuprofen-based painkillers - typically Nurofen Plus - and the damage this caused to their health.
The side-effects included gastrointestinal ruptures, renal failure, anaemia and severe hypokalaemia - low potassium in the blood that can cause an irregular heartbeat or paralysis.
The 27 patients either sought treatment for opioid addiction or were referred to a hospital addiction service in Australia from 2005 to 2008.
"A significant proportion of patients reported initiating use of over-the-counter ... products for painful conditions, including back pain and headaches, and subsequently escalating the dose," the Sydney Morning Herald quoted Matthew Frei of Monash University's School of Psychology and Psychiatry as saying.
"A mean dose range of 34 to 47 tablets per day was reported in this case series," he said, while adding that one patient was taking up to 100 tablets a day.
While the cases gave no indication of the prevalence of painkiller addiction in Australia, Frei said it highlighted the need for increased scrutiny by the medical community.
"Given that these drugs are likely to remain available without prescription in Australia, physicians should ask specifically about non-prescribed analgesics when taking a medication history," he said.
"Pharmacy personnel should consider the risk of misuse when supplying these combination analgesic products," he added.
The findings were published in the Medical Journal of Australia.