They’re the pain medicines found in most medicine cabinets. Acetaminophen i.e. Tylenol, aspirin, and ibuprofen are taken by millions of Americans each day. But are they dangerous in the long run if taken daily? Given that aspirin and ibuprofen can cause short term problems if used too frequently or in doses that are too high the question arises as to whether there is a risk for long term problems as well. In particular, there is a need to establish the connection between usage of acetaminophen i.e. Tylenol and kidney problems. “I use Tylenol when I get a migraine, or have a sinus headache. Occasionally I take it to relieve body aches and pains as well,” says Suzanne Polizzi who has to take Tylenol approximately once a month. But what about those who take say, aspirin, or ibuprofen once or twice a day? Is there danger in the regular long term use of these over the counter medicines? “I take Tylenol under the assumption that it is completely safe. I think the risks are in such a small percentage of the population that it doesn’t really bother me,” says Suzanne. Suzanne is mostly right. The latest evidence, out of the archives of internal medicine, shows out of three medicines--Tylenol, aspirin, and anti-inflammatories such as ibuprofen--Tylenol is the one most likely to cause troubles. Aspirin and ibuprofen can both cause short term kidney failure if used in sick persons or if given in excessively high doses. But there is conflicting evidence on whether daily, regular use of aspirin or ibuprofen can cause longer term decline in kidney function. This study was reassuring in that it found that taking aspirin or ibuprofen daily causes no significant kidney function decline. But in women, there can be a potential problem with daily use of Tylenol, albeit in a relatively small percentage of cases. “According to this study the individuals who are at greatest risk for kidney dysfunction are those who have been taking daily doses of two to three tablets for ten years or more. I think anyone who is taking any medicine with that regularity for that duration of time should be checked by their doctor. That being said I think the risk of kidney damage from acetaminophen is quite low,” says Dr. Jonathan Winston, a kidney specialist. And while most women do not experience kidney insufficiency when taking acetaminophen i.e. Tylenol, for women with a history of kidney problems, acetaminophen should be used judiciously. “Even safe drugs when taken at extraordinary doses for decades at a time have the potential to be harmful. People shouldn’t be self-medicating themselves for that period of time,” advises Dr. Winston.