Many medications can affect the kidneys, but the risk depends on the specific drug, the dose, how long it’s taken, and whether someone already has kidney disease. It’s generally not accurate to say there are “eight pills you should never take”—many of these medicines are safe and effective when used appropriately.
Here are eight common categories of medications that can cause kidney problems in some people:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen and Naproxen.
- Can reduce blood flow to the kidneys, especially if you’re dehydrated, older, or have kidney disease.
- Certain antibiotics, including aminoglycosides (such as Gentamicin) and, less commonly, medications like Vancomycin.
- Risk is higher with prolonged treatment or high doses.
- Some antiviral medications, such as Acyclovir in high doses or Tenofovir disoproxil fumarate in susceptible individuals.
- Certain chemotherapy drugs, including Cisplatin.
- Kidney function is closely monitored during treatment.
- Diuretics (“water pills”), such as Furosemide.
- Can contribute to dehydration and electrolyte imbalances if not used properly.
- ACE inhibitors and ARBs, such as Lisinopril or Losartan.
- These can cause a small initial drop in kidney function but are often kidney-protective in the long term for conditions like diabetes and high blood pressure. They should not be stopped without medical advice.
- Lithium, used to treat certain mental health conditions.
- Long-term use can affect kidney function, so regular blood tests are recommended.
- High-dose proton pump inhibitors (PPIs), such as Omeprazole.
- Rarely, they can cause inflammation of the kidneys (acute interstitial nephritis), particularly with prolonged use.
How to reduce your risk
- Take medications only as directed.
- Stay well hydrated unless your healthcare professional has advised you to restrict fluids.
- Tell your clinician about any history of kidney disease.
- Have kidney function monitored if you’re taking medications known to affect the kidneys.
- Avoid combining medications that can stress the kidneys unless your healthcare team recommends it.
If you have a specific medication in mind, I can explain how it affects the kidneys, how common the risk is, and what precautions are recommended.
