Powerful painkillers containing codeine have been linked to dozens of fresh cases of bleeding stomach ulcers and renal failure, reinvigorating debate about abuse of the popular drugs.

Concerns centre on codeine combination medicines such as Nurofen Plus, available over the counter in pharmacies.

A report presented at a national public health conference in Brisbane showcased 77 problematic cases, including 39 cases of perforated stomach ulcers and 15 cases of renal failure. Some patients required dialysis and one died.

The study leader and a senior medical adviser in the drugs and poisons unit at the Victorian Department of Human Services, Dr Malcolm Dobbin, said the misuse of ibuprofen-codeine compound drugs might be causing more harm than any other analgesic containing codeine.

''Some patients are clearly codeine-seekers and may conceal or deny their use,'' he told the doctors' publication Medical Observer.

''Other patients ... have been shocked to find out they are addicted.''

The over-the-counter status of the drug is under review, with a federal Health Department committee decision due in August.

Drug specialists and doctors say restricting access to the drugs would be impractical and inconvenient, given that codeine abuse ''is relatively limited'' in Australia.

But media reports in January claimed 7000 Australians had joined an online forum for people addicted to Nurofen Plus, the strongest tablet in the range.

And a Melbourne report published in the Medical Journal of Australia said recreational misuse of Nurofen Plus had become a ''significant problem''.

Nurofen Plus manufacturer Reckitt Benckiser said there was no evidence the use of non-prescription medicines containing low doses of codeine led to abuse if taken for a short time and according to directions. AAP