Phenacetin is a non-opioid analgesic without anti-inflammatory properties, inhibits COX-3 activity. Target: COXPhenacetin is a pain-relieving and fever-reducing drug, Phenacetin was withdrawn from the Canadian market in June 1973 due to concerns regarding nephropathy. the clinical and laboratory data were compatible with "phenacetin nephritis" as described in Europe and Australia and recently in the United States and Canada. This report evaluates the findings in the 23 cases and cautions against the use of phenacetin, particularly in patients with impaired renal function. Phenacetin has been linked to renal papillary necrosis in human beings