Before I begin this post be aware as I always state my post is information to help you become more knowledgeable about protecting your kidneys from disease, or progression of disease if you already have kidney disease. I am not telling people to stop taking prescribed medication, or medication ordered by your doctor. However, being knowledgeable and having good communication with your doctor is of utmost importance. You will find reading information below, and a video to help explain this topic even further.
Over the Counter medications of certain kinds can actually harm your kidneys. I feel like many people don’t know this, or maybe feel like because it is available at the store it is safe. I know for me, before I was diagnosed I had very frequent headaches and awful muscle pains mostly at night causing me to lose sleep. I took Ibuprofen often and even though I knew there was a risk, I didn’t know I had kidney disease, and I needed to sleep, This use of Ibuprofen may have helped to further damage my kidneys especially since I used it long term. My doctors knew I was taking it, though, as needed for pain. But, they never really ask how often as needed is now do they? There are also prescription medications that can harm the kidneys. I would recommend you always have a basic urine test, and blood work done before starting any new medication, but especially if you have kidney disease.
These are the most common medications that can cause kidney damage.
1- NSAIDS: these are over the counter medications used for fever and pain and include Naproxen, Advil, Ibuprofen, Aspirin- see note, and many others. Research any medications before you take them to see if they qualify as a NSAID. Tylenol, which can also harm the liver in high doses if used too often, or too much can also possibly harm the kidneys. Always check with your doctor as to appropriate dose and how often. A lot of other medications contain Tylenol also called MPAP, Acetominophen and other generic names in combination. Excedrin Migraine is one that has Aspirin, Acetominophen and Caffeine. Be a smart consumer and research all of the active ingredients which will be on the label. In the article below you will see that a baby Aspirin which is usually 81 mg per dose, and usually prescribed for Heart Disease is going to be safe, but still discuss with your doctor. I have not found any narcotic medications that are safe for the kidney disease patient. With all of that said everyone deserves to be pain free, and have their pain concerns addressed. Discuss with your doctor to find a pain curative for you. For pain, and I am stage 3, the only thing my Nephrologist has okayed for me to take is Tylenol, or a baby Aspirin. I do use peppermint oil in a carrier oil, and Bengay for pain. Bengay does contain Aspirin so clear it with your doctor first. Drink lots of water, unless you are on fluid restrictions in which case you should be being monitored by your doctor if you need something for pain other than they say is safe.
2- Cold, allergy and flu medications: A lot of these contain Tylenol or other NSAID. I already discussed those. But, they also contain medications that can make you very drowsy causing you to not drink enough and cause dehydration, or increase blood pressure. Both of these things can damage the kidneys especially if you have high blood pressure. This can be very dangerous. My family knows that if I am sick to make sure I am awake and drinking a full cup of water every hour, especially if I have taken medication. If I absolutely have to take Nyquil because nothing else will work I take a half or quarter of the dose, and make my doctor aware. If I have a cold or allergies my doctor said I can take Claritin also known as Loratadine, Benadryl also known as Diphenhydramine, or Coricidin HBP for severe illness. Claritin should not make you drowsy but both Benadryl and Coricidin HBP may make you very drowsy or even not be able to stay awake. If you are taking any others than the ones I mentioned that are safe talk to your doctor to see if you can switch to a more kidney friendly one. Also, they often are combined with other drugs so always read the labels and active ingredients.
3- Heartburn or nausea: When I was first diagnosed I had nausea so bad I could not eat anything and could only drink ice water. Initially, because my GP did not suspect kidney disease as I had no reason to suspect it in her mind, she ordered Prilosec for me. It probably caused my kidney damage to worsen, at least in the short term, until we learned what really was wrong and the medicine was stopped. Proton Pump Inhibitors are damaging to the kidneys. Zantac, Prilosec, Tagamet and others are all nephrotoxic. You should request your doctor to prescribe you a non PPI to control your GERD, heartburn or nausea related to those ailments. The only heartburn my doctor has said is safe is Pepcid also called Famotadine. Be careful if you are taking Tums in large amounts as they contain high doses of Calcium. Maalox, and others like Maalox are another type of heartburn medicine that is high in Aluminum and sometimes Magnesium, both which can be harmful to kidneys in high amounts, or if you already have disease especially if you don’t know you have kidney disease as is often the case for most people.
4- Antibiotics: Penicillin and derivatives of Penicillin, Aminoglycoside antibiotics and others may cause harm to the kidneys. When I was 21 I had strep throat confirmed by throat culture. At that time I was working 12 hour night shifts at my local hospital. I was prescribed Penicillin and sent on my way. After a few days of taking it I woke up with swollen eyes and a rash covering my whole body with sticky fluid. Of course, being young, half asleep and not thinking clearly I figured I had an allergic reaction took Benadryl and went back to bed. While the Benadryl stopped the reaction I now wonder if they reaction may have damaged my kidneys. Of course being young and dumb, and the rash went away I did not report this to my doctor which I didn’t even really have one at 21. This would be my biggest thing to tell people. Always discuss antibiotics with your doctor if you have kidney disease. I had to take one recently and Doxycycline was allowed. Be sure to tell the pharmacist you have kidney disease so they can teach you how to take the medication properly to avoid further damage. If you take a medicine but don’t have kidney disease take note if you notice you are not urinating as much as you normally do and let your doctor know.
5- Drugs that treat Cancer are sometimes harmful to the kidneys. Obviously if you have Cancer you will want to seek treatment. Always discuss with your doctor monitoring your labs, and urine to be sure your kidneys are functioning well.
6- IV Contrast Dyes: These are typically used during certain tests or procedures. Again, always discuss with your doctor to be sure it is safe for you to have the procedure if you have kidney disease, and what to do to prevent kidney damage from occurring. Typically after such a procedure you will be instructed to drink lots of water to help clear the dye from the kidneys.
A special note, which will be covered more in one of the links below, if you are taking high blood pressure medications and you become sick with a cold, flu, diarrhea or nausea you will want to let your doctor know. If you are not taking in enough fluids, and become dehydrated there is a very good chance your blood pressure may go down even if you have high blood pressure. Your doctor may ask you to monitor your blood pressure and possibly hold your medication it is below a certain number until you can resume normal eating and drinking. Do not make these decisions on your own, it can be very dangerous.
A lot of vitamins, supplements and other so called natural remedies have never been studied in people with kidney disease. Always use caution and ask your doctor to advise prior to taking. Your doctor should always know any medications, herbs, supplements, vitamins etc that you are taking, whether they advised you to or not. Illicit or illegal drugs, especially Cocaine and Methamphetamines are also very harmful to drugs. Seek help to stop taking these asap. Alcohol is also toxic to the kidneys, and smoking may cause narrowing of the blood vessels which can lead to kidney damage.
https://www.healthlinkbc.ca/health-topics/tv7198
https://www.kidney.org/news/kidneyCare/winter10/MedicinesForPain
Living Life With CKD 
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