All pain medications listed in the text and table of this site have side effects. In addition to those listed as special risks for each of these medications, there are serious but unusual side effects that occur rarely such as decreased production of blood cells by the body. All medications are risky for anyone who may be pregnant or who is breast feeding and require special attention before prescribing. With the exception of over-the-counter drugs, all of these medications should only be taken with a prescription for the patient and under the direction of a physician. Liver toxicity and kidney toxicity usually do not occur, but routine blood tests for signs of these problem are essential if they are taken on an ongoing basis. Narcotic drug dependency, addiction, and potiential for abuse are risks that can be controlled and monitored but are always a consideration when these medications are prescribed.