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To the Editor:—
The article and editorials in the May 11 issue of The Journal (184:435, 494) regarding the use of analgesics in chronic renal disease have certain amusing as well as dismaying overtones. The patient who consumes analgesic tablets in a dosage of 10 to 30 daily over a period of years will not profit from a warning on the label and scarcely deserves this protection. "Labels recommending no more than six tablets in 24 hours and the avoidance of long-continued use" will hardly meet the problem of the patient who over-works, consumes generous quantities of alcohol, smokes excessively, and then consumes excessive quantities of analgesics until the next cocktail hour. This is the real vicious circle which needs attention.Almost without exception the drug which is introduced as highly effective and utterly without adverse reactions is eventually shown not to be devoid of side effects. The real
Shaw EB. Analgesics and Chronic Renal Disease. JAMA. 1963;185(6):545. doi:10.1001/jama.1963.03060060143034