Some medications can damage the kidneys, especially if taken in high doses, for long periods, or by people who already have kidney disease, dehydration, diabetes, or high blood pressure. However, many of these medicines are safe when used appropriately and under medical supervision.
Here are eight commonly used medications or medication groups that can pose a risk to the kidneys:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and diclofenac.
- Can reduce blood flow to the kidneys.
- Risk increases with dehydration, older age, or existing kidney disease.
- Certain antibiotics
- Examples include gentamicin, tobramycin, and vancomycin.
- Some antibiotics can be directly toxic to the kidneys and may require dose adjustments.
- Contrast dye used for some CT scans and angiograms
- Iodinated contrast can sometimes cause temporary kidney injury, particularly in people with chronic kidney disease.
- Lithium
- Used to treat bipolar disorder.
- Long-term use can impair kidney function, so regular blood and kidney tests are important.
- Certain antiviral medications
- Examples include acyclovir (especially at high doses) and tenofovir.
- Adequate hydration and dose adjustments can reduce the risk.
- Some chemotherapy drugs
- Cisplatin and methotrexate are examples that may affect kidney function.
- Patients receiving these drugs are closely monitored.
- Certain diuretics (“water pills”)
- Medications such as furosemide or hydrochlorothiazide can contribute to dehydration and electrolyte imbalances, which may stress the kidneys if not used appropriately.
- High-dose or prolonged use of proton pump inhibitors (PPIs)
- Examples include omeprazole and pantoprazole.
- Rarely, they can cause kidney inflammation (acute interstitial nephritis) or be associated with chronic kidney problems.
How to reduce your risk
- Take medications only as directed.
- Stay well hydrated unless your healthcare provider has advised otherwise.
- Avoid taking NSAIDs frequently without medical advice.
- Tell your healthcare provider about all prescription drugs, over-the-counter medications, and supplements you use.
- Have your kidney function monitored if you’re taking medications known to affect the kidneys.
If you have chronic kidney disease, diabetes, high blood pressure, or are over age 65, it’s especially important to consult your healthcare provider or pharmacist before starting any new medication, including over-the-counter pain relievers.
