10 Common Medications That Can Affect Your Kidneys — And How to Protect Yourself
The viral-style claim that these medicines will “silently damage your kidneys” needs some qualification. Many medicines are perfectly appropriate and can even protect kidney function. The risk depends on the drug, dose, duration, kidney function, dehydration, and other medicines you’re taking.
1. Ibuprofen and other NSAIDs
Examples include ibuprofen, naproxen, diclofenac, meloxicam, and celecoxib. Regular or high-dose use can reduce blood flow to the kidneys and increase the risk of acute kidney injury, particularly if you’re dehydrated or already have kidney disease.
2. High-dose aspirin
Aspirin at more than 325 mg/day falls into the NSAID category of concern for kidney health. Low-dose aspirin prescribed for cardiovascular protection is a different situation and should not be stopped without medical advice.
3. Certain antibiotics
Some antibiotics can directly affect the kidneys, while others can accumulate when kidney function is reduced. That doesn’t mean you should avoid antibiotics—the infection itself may be much more dangerous. Your clinician may simply adjust the dose according to your kidney function.
4. ACE inhibitors
Medicines such as lisinopril can cause changes in kidney function, particularly in certain circumstances. Importantly, ACE inhibitors can protect the kidneys in many people with kidney disease, so don’t stop one simply because you’ve seen a kidney-warning list.
5. ARBs
Examples include losartan and valsartan. Like ACE inhibitors, they can affect kidney function under certain circumstances but are also important kidney-protective medicines for many patients.
6. Diuretics (“water pills”)
Medicines such as furosemide can be essential for controlling blood pressure or fluid buildup. However, dehydration combined with a diuretic can increase the risk of acute kidney injury.
7. Some antiviral medicines
Certain antivirals can accumulate when kidney function is impaired, and some have potential kidney toxicity. Doses may need to be adjusted according to eGFR.
8. Some antifungal medicines
Certain antifungals can affect kidney function or require dose adjustments when kidney function is reduced. Your prescriber should take your eGFR into account.
9. Certain cancer medicines
Some chemotherapy and other cancer treatments can affect the kidneys. These drugs are generally given with careful monitoring because the benefits may greatly outweigh the risks.
10. Contrast agents used for some scans
Contrast isn’t a daily medication, but certain contrast agents used during imaging can pose kidney risks in susceptible people. Always tell the imaging team if you have kidney disease and provide a complete medication list
