Some medications can harm the kidneys, especially if they’re taken in high doses, for long periods, or by people who already have kidney disease. It’s important not to stop a prescribed medication without talking to the clinician who prescribed it, because the benefits may outweigh the risks for you.
Here are eight categories of medicines that can affect kidney health:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and diclofenac. Regular or high-dose use can reduce blood flow to the kidneys, particularly in older adults, people with kidney disease, or those who are dehydrated.
- Certain antibiotics, including aminoglycosides (such as gentamicin) and some others, especially when given in high doses or over extended periods. Doctors often monitor kidney function during treatment.
- Some antiviral medications, including drugs like acyclovir or tenofovir in certain situations, can affect the kidneys and may require dose adjustments.
- Certain chemotherapy drugs, such as cisplatin, are known to have potential kidney toxicity. Patients receiving these medications are typically monitored closely.
- Lithium, a medication used to treat bipolar disorder, can affect kidney function with long-term use. Regular blood tests are recommended for people taking it.
- Some diuretics (“water pills”), such as furosemide or hydrochlorothiazide, can contribute to dehydration or electrolyte imbalances that may stress the kidneys if not managed appropriately.
- Proton pump inhibitors (PPIs), including omeprazole and pantoprazole, have been associated with rare cases of kidney inflammation and, in some studies, a higher risk of chronic kidney disease. They remain appropriate for many people when used for valid medical reasons.
- Certain blood pressure medicines, including ACE inhibitors and ARBs, can temporarily change kidney function. Despite this, they often protect the kidneys over the long term in people with conditions such as diabetes or protein in the urine. Healthcare providers usually check kidney function and potassium levels after starting or increasing the dose.
To help protect your kidneys:
- Take medications exactly as directed.
- Stay well hydrated unless you’ve been told to limit fluids.
- Avoid taking multiple NSAIDs at the same time.
- Tell your healthcare provider about all prescription drugs, over-the-counter medicines, and supplements you use.
- Have your kidney function monitored if you’re taking medications that can affect the kidneys.
If you have existing kidney disease, diabetes, high blood pressure, or are over age 65, it’s especially important to discuss medication safety with your healthcare provider before starting new medicines.
