Medication Safety and Kidney Disease

Medications save and improve lives, but they can also impact your kidneys. When you have chronic kidney disease (CKD), medications can build up in your body and cause harm. Your care team may adjust the following common medications if you have CKD.

NSAIDs

NSAIDs (non-steroidal anti-inflammatory drugs) are a type of prescription and over-the-counter medication commonly used for pain and inflammation. Some examples are ibuprofen (Advil® or Motrin®), meloxicam (Mobic®), and naproxen (Aleve®). These are not recommended if you have CKD because they can reduce blood flow to the kidneys.

Cholesterol medication

Cholesterol medications, known as "statins," reduce the risk of cardiovascular disease, including heart attack and stroke. With CKD, your dose of certain cholesterol medications may need to be changed.

Iodinated intravenous contrast (dye)

Diagnostic tests like CT scans and angiograms help diagnose certain conditions. Many use iodinated intravenous contrast (dye) that may be harmful if you have CKD. Let your provider know that you have CKD before they perform these tests.

Cold and flu medication

Some cold and flu medications, especially for head congestion, can contain NSAIDs, which should be avoided with CKD. If you have high blood pressure, take caution if you use the nasal decongestants pseudoephedrine (Sudafed®) or phenylephrine (Sudafed PE®) as they can raise your blood pressure.

Pain Medication

When you have CKD, certain types of pain medication can build up in the body and cause serious problems. Ask your care team for help with these medications as some may need dose adjustments.

• Opioid-type oral analgesics (oxycodone, hydrocodone, hydromorphone, etc.) should only be used under the care of a healthcare provider, as many require dose adjustments.
• Pain associated with diabetic neuropathy is treated with other medications like gabapentinoids (Lyrica®) and SNRIs (antidepressant medications that also alleviate pain) and may require dose adjustments.

For safer pain relief alternatives to NSAIDs, try acetaminophen and topical analgesics (creams and ointments). You can also try pain relief treatments without the use of medicine like physical therapy, mind-body work, and exercise.

Other safe medications in the right doses

Common medications that are safe to take but may need dose adjustments include:

• Antibiotics, like ciprofloxacin and amoxicillin
• Medications for diabetes, like metformin and insulin
• Acid reducers, like famotidine (Pepcid®) and nizatidine (Axid®)
• Blood thinners, like apixaban (Eliquis®) and rivaroxaban (Xarelto®)
• Antihistamines, like loratadine (Claritin®), fexofenadine (Allegra®), and levocetirizine (Xyzal®)
• Pain medications, like opioids and gabapentin (Neurontin®)
• Medications for gout, like allopurinol (Zyloprim®) and colchicine (Colcrys®)

Medication safety steps to take

Use these tips to ensure that your medications are safe for your kidneys:

• Let all your providers (including primary care, other specialists, and dentists) know that you have CKD so they can change medications that could harm your kidneys.
• At the pharmacy, ask to speak to the pharmacist to review your medications and check for safety.
• Bring all medications to your office visits including prescriptions, over-the-counter (OTC) medications, supplements, vitamins, and herbals for your care team to review.
• Always check with your care team or pharmacist before taking OTC medications for cold symptoms, pain, digestive distress, and other common symptoms.

We're here to help

Reach out to your care team for help managing your medications and to get your questions answered.

This serves only as a guide. Talk with your healthcare provider for more information based on your health needs.