Several commonly used medicines can affect kidney function, particularly when taken at excessive doses, for too long, or in people who are dehydrated or already have reduced kidney function.
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National Kidney Foundation
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8 medications to use with particular caution
Ibuprofen and other NSAIDs — Ibuprofen, naproxen, diclofenac, and similar anti-inflammatory painkillers can reduce blood flow to the kidneys. High doses or prolonged use increase the risk of acute kidney injury and worsening chronic kidney disease.
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National Kidney Foundation
High-dose aspirin — Aspirin above about 325 mg/day can act like an NSAID and affect kidney blood flow. Low-dose aspirin prescribed for cardiovascular protection is a different situation and should not be stopped without medical advice.
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National Kidney Foundation
Certain antibiotics — Some antibiotics can directly affect the kidneys, while others are cleared through the kidneys and can accumulate if kidney function is reduced. Doses may need adjustment according to kidney function.
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National Kidney Foundation
ACE inhibitors and ARBs — Drugs such as lisinopril and losartan can actually protect the kidneys in many people, but kidney function and potassium may need monitoring. The risk of acute kidney injury increases in situations such as dehydration or when combined with NSAIDs and certain diuretics.
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Diuretics (“water pills”) — Medicines such as furosemide can be very beneficial, but excessive dosing can contribute to dehydration and electrolyte abnormalities, potentially stressing the kidneys.
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National Kidney Foundation
Lithium — Long-term lithium treatment can affect kidney function, and lithium levels can become dangerously high when the kidneys cannot clear it adequately. Regular medical monitoring is important.
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National Kidney Foundation
Certain antivirals and antifungals — Some are eliminated through the kidneys and may accumulate when kidney function is impaired; certain drugs in these groups can also directly cause kidney injury.
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National Kidney Foundation
Some bowel-preparation medicines containing oral sodium phosphate — These can cause serious kidney problems in susceptible people, particularly those with kidney disease or those taking medicines that affect kidney blood flow.
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National Kidney Foundation
The important takeaway
Don’t assume a medicine is dangerous simply because it appears on this list. Many of these medications are safe and beneficial when used at the appropriate dose. The risk depends on the specific drug, dose, duration, kidney function, hydration, and other medicines being taken.
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If you have kidney disease, diabetes, high blood pressure, or take several medicines, have a doctor or pharmacist review all prescription medicines, over-the-counter products, and supplements you use. And don’t stop a prescribed medicine on your own.
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