8 Medicines That Can Harm the Kidneys in Certain Situations
The claim that certain pills simply “damage your kidneys” is too broad. Most medicines are safe when appropriately prescribed and dosed, but some can cause kidney injury or become risky when you’re dehydrated, have existing kidney disease, or take interacting medications.
Eight important categories include:
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NSAID painkillers — Ibuprofen, naproxen, and diclofenac can reduce blood flow to the kidneys and increase the risk of kidney injury, particularly with dehydration or pre-existing kidney disease.
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High-dose aspirin — Regular high doses used for pain are more concerning for the kidneys than the low-dose aspirin sometimes prescribed for cardiovascular protection.
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Certain antibiotics — Some antibiotics, including aminoglycosides, can cause kidney injury. Others require dose adjustments when kidney function is reduced.
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Vancomycin — This antibiotic can cause kidney toxicity, particularly at high blood concentrations or when combined with other kidney-stressing medicines.
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Some antiviral medicines — Certain antivirals can affect kidney function and may require careful dosing or monitoring.
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Lithium — Long-term lithium treatment can affect kidney function in some people and generally requires regular monitoring.
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Some acid-reducing medicines — Proton-pump inhibitors such as omeprazole have been associated with certain kidney problems, including acute interstitial nephritis, although serious complications are uncommon.
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Certain diuretics and blood-pressure medicines — These aren’t inherently “bad for the kidneys.” However, they can contribute to acute kidney problems in situations such as severe dehydration or when combined with other medicines, and some are actually used to protect the kidneys in appropriate patients.
Don’t stop prescribed medication on your own
This is especially important with blood-pressure medicines, lithium, antibiotics, or cardiovascular medications. The risk of stopping treatment can be greater than the potential medication risk.
If you’re taking several medicines, a pharmacist or doctor can review your medications and determine whether you need kidney-function tests (creatinine/eGFR) or dose adjustments.
Urgent medical attention is appropriate for markedly reduced urination, severe swelling, confusion, persistent vomiting, or other signs of potentially serious illness.
A more accurate headline would be:
“8 Medicines That Can Affect Kidney Function—and When You Should Be Cautious”
