Medicine can play an important role in protecting your health. But if you have chronic kidney disease, certain medications can have risks. That’s why using caution before taking medications matters. Here’s what to know.

Many medications, including over-the-counter ones, can affect kidney function. 

For someone with healthy kidneys, this may not be an issue. However, if you have chronic kidney disease, caution is important, according to Geisinger kidney doctor Jamie Green, MD. 

Medications that can affect kidney function include:

NSAIDs, like Ibuprofen or naproxen
Certain antibiotics
Acid reducers
Supplements
Diuretics
Contrast dye used for certain imaging, like MRI or CT

Other medications are cleared by the kidneys but won’t harm them directly. These include:

Some antibiotics
Medications to treat diabetes
Heart medication

To avoid potential complications, your healthcare provider may need to adjust your dose.

How do medications affect your kidneys?

Medications can impact the kidneys in a few ways.

Causing kidney damage

Some medications can directly damage the kidneys, which can lower kidney function. “Damaged kidneys have to work harder to filter waste,” Dr. Green says. “Knowing which medicines are safe can help you protect your kidneys and avoid further damage.”

Causing high amounts of medicine in the body

Your kidneys help remove certain medications from your body. But when your kidneys are damaged, these medications can build up in your blood and make you sick. Ask your healthcare provider if your dosage needs to be adjusted because of your kidney disease.

Reducing blood flow

Some drugs, like NSAIDs (non-steroidal anti-inflammatory drugs), can reduce blood flow to your kidneys. This can lower the amount of oxygen and nutrients they get. Over time, that lack of blood flow and oxygen can damage healthy tissue. Examples include ibuprofen (Advil, Motrin) or naproxen (Aleve). Patients with kidney disease should avoid all NSAIDs.

Taking medicine the right way

No matter what medicine you’re currently on, using caution will help protect your kidneys. To keep your kidneys as healthy as possible, consider these tips:

Have a conversation

“Before taking any new medicine, including prescription medications, over-the-counter medicines or herbal supplements, talk to your healthcare provider,” advises Dr. Green. They can help you find the right medication to help you manage symptoms. And keep your kidneys working as well as possible. They can also make changes to your doses or medicine schedule.

Use a single pharmacy

Filling all your prescriptions at the same pharmacy can help you stay organized. It can also help you avoid potential drug interactions. Your pharmacist may also recommend alternatives that will be safer for your kidneys.

Be mindful of labels

Many medications, especially cold medicine, can raise blood pressure. “Increased blood pressure can be harmful to your kidneys,” says Dr. Green. To be safe, always read the label and ask your health care professional for advice. If you’re not sure, take something else.

Ask for a medication review

If you’re taking multiple medications, your pharmacy team may recommend a medication review. They can look at the list of all your medications, including over-the-counter ones, vitamins and supplements to check for potential interactions or side effects. They can also help determine if the medications you’re on are necessary, effective and above all, safe.

Pay attention to how you feel

Kidney damage often causes no symptoms early on. But if a medication is stressing your kidneys, you may notice signs such as:

Swelling in your legs or feet

Tiredness
Reduced urination
Back or side pain
Confusion
Blood in the urine

Contact your healthcare provider if you notice new symptoms, or if your current symptoms have gotten worse.

Keep the lines of communication open

Managing chronic kidney disease often involves an entire care team. Keeping them in the loop on changes to your medication or overall health can help everyone be on the same page. And being on the same page can help you achieve your health goals.

See also:

Learn about kidney care at Geisinger
Can kidney stones cause kidney failure?
What’s that pain in your side?