8 Common Medications That Can Affect Kidney Health When Used Inappropriately
This headline needs an important qualification: these aren’t medicines everyone should avoid. Some can be very beneficial when prescribed correctly, but excessive doses, prolonged use, dehydration, or reduced kidney function can increase the risk of kidney injury or medication buildup.
1. Ibuprofen and other NSAIDs
Examples include ibuprofen, naproxen, diclofenac and celecoxib. High doses or long-term use can reduce blood flow to the kidneys and increase the risk of acute kidney injury. The risk is particularly concerning with kidney disease or dehydration.
2. High-dose aspirin
Aspirin at more than 325 mg/day has NSAID-like kidney risks. This is different from low-dose aspirin that a doctor may prescribe for cardiovascular protection.
3. Certain antibiotics
Some antibiotics can directly affect the kidneys, while others are primarily cleared by the kidneys and may accumulate if the dose isn’t adjusted for reduced kidney function.
4. Certain antiviral and antifungal medicines
Some of these drugs can be nephrotoxic or require dose adjustments according to kidney function. That doesn’t mean they should be avoided when they’re medically necessary.
5. Lithium
Long-term lithium treatment can affect kidney function, particularly at higher blood concentrations. People taking lithium generally need appropriate blood-level and kidney monitoring.
6. Diuretics (“water pills”)
Medicines such as furosemide can be extremely useful for heart failure, high blood pressure and fluid retention. But excessive dosing can contribute to dehydration and electrolyte abnormalities, which can put stress on the kidneys.
7. ACE inhibitors and ARBs
These deserve special clarification. Medicines such as lisinopril and losartan are not simply “kidney-damaging drugs.” In fact, they can protect the kidneys and slow kidney disease progression in many people. However, kidney function and potassium need monitoring, particularly during dehydration or when combined with NSAIDs.
8. Oral sodium-phosphate bowel preparations
Certain phosphate-containing preparations used for bowel cleansing can cause serious kidney injury in susceptible people. People with kidney disease and certain other risk factors should discuss safer alternatives with their healthcare professional.
