Headlines like “Eight pills you shouldn’t take because they damage your kidneys” are often misleading. Many medications can affect the kidneys only in certain situations, such as high doses, long-term use, dehydration, or pre-existing kidney disease. They should not be stopped without medical advice if they’ve been prescribed.
Some medications that are known to require caution include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Examples: ibuprofen, naproxen.
- Can reduce blood flow to the kidneys, especially in older adults, people with kidney disease, heart failure, or dehydration.
- Certain antibiotics
- Some antibiotics can affect the kidneys and may need dose adjustments in people with reduced kidney function.
- Some antiviral medications
- A few antivirals can stress the kidneys, particularly if doses aren’t adjusted appropriately.
- Certain diuretics (“water pills”)
- Can contribute to dehydration or electrolyte imbalances if not monitored.
- Lithium
- Long-term use can affect kidney function, so regular blood tests are typically recommended.
- Some chemotherapy drugs
- Certain cancer treatments can be nephrotoxic and are carefully monitored.
- High-dose proton pump inhibitors (rare association)
- Long-term use has been linked to certain kidney conditions in some people, though the absolute risk is low.
- Some diabetes medications
- A few require dose adjustments or may not be suitable at lower levels of kidney function.
Help protect your kidneys
- Take medications exactly as directed.
- Stay well hydrated unless your clinician has told you to limit fluids.
- Tell your healthcare provider about all prescription drugs, over-the-counter medicines, and supplements you take.
- Have your kidney function checked if you have kidney disease, diabetes, high blood pressure, or take medicines that require monitoring.
If you have kidney disease, don’t stop a prescribed medication on your own. Instead, ask your clinician or pharmacist whether the dose needs adjustment or whether a safer alternative is available.
