Headlines like “Eight pills you shouldn’t take because they damage your kidneys” are often misleading. The reality is that many medications can affect the kidneys in certain people or at certain doses, but they can also be safe and effective when used appropriately.
Some medicines that are known to carry a risk of kidney injury include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, especially with frequent use, dehydration, or existing kidney disease.
- Certain antibiotics, including aminoglycosides (used mainly in hospitals) and, less commonly, some others in susceptible people.
- Some antiviral medications, which may require dose adjustments in people with reduced kidney function.
- Diuretics (“water pills”), which can contribute to dehydration and affect kidney function if not used appropriately.
- ACE inhibitors and ARBs (blood pressure medicines). These can cause a small rise in kidney blood tests when started, but they also protect the kidneys in many people with diabetes or chronic kidney disease. They should not be stopped without medical advice.
- Lithium, particularly with long-term use or high blood levels.
- Certain chemotherapy drugs, which are monitored closely because of potential kidney effects.
- Some proton pump inhibitors (PPIs), such as omeprazole, have been linked to rare kidney inflammation and may be associated with kidney disease in some studies, though the overall risk for most users is low.
To help protect your kidneys:
- Take medications only as directed.
- Stay well hydrated unless you’ve been told to limit fluids.
- Tell your healthcare provider about all prescription drugs, over-the-counter medicines, and supplements you use.
- Have your kidney function checked if you’re taking medications that can affect the kidneys, especially if you’re older or have diabetes, high blood pressure, or existing kidney disease.
- Don’t stop prescribed medications without discussing it with your healthcare provider, as the benefits may outweigh the risks.
If you’re concerned about a specific medication or supplement, let me know its name, and I can explain how it may affect the kidneys and whether any precautions are recommended.
