8 Common Medications That Can Affect Kidney Health When Misused
The headline needs an important qualification: these medicines aren’t automatically “bad for your kidneys.” Many are safe and beneficial when prescribed and taken correctly. The risk can increase with excessive doses, prolonged use, dehydration, drug interactions, or existing kidney disease. NIDDK+1
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NSAID painkillers — such as ibuprofen, naproxen, diclofenac, and high-dose aspirin. High doses or long-term use can reduce blood flow to the kidneys and contribute to kidney injury. The risk is particularly concerning with dehydration or pre-existing kidney disease. NIDDK+1
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ACE inhibitors — such as lisinopril. These medicines can actually protect kidney function in many people, particularly those with certain types of kidney disease, but kidney function and potassium sometimes need monitoring, especially when someone becomes dehydrated. NIDDK+1
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ARBs — such as losartan. Like ACE inhibitors, ARBs can slow kidney disease, but they can require monitoring of kidney function and potassium and may become problematic in certain circumstances, including significant dehydration. NIDDK+1
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Diuretics (“water pills”) — such as furosemide or hydrochlorothiazide. They are commonly used to treat high blood pressure and fluid retention. Excessive fluid loss can contribute to dehydration and reduced kidney function. NIDDK+1
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Certain antibiotics — some antibiotics can directly affect the kidneys, while others are primarily cleared by the kidneys and may accumulate when kidney function is reduced. Doses sometimes need adjustment according to eGFR. National Kidney Foundation+1
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Certain antivirals and antifungals — some can affect kidney function or accumulate when the kidneys aren’t filtering normally, making appropriate dosing important. National Kidney Foundation
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Lithium — this medication can affect kidney function, particularly with long-term treatment, so people taking it generally require medical monitoring.
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Some medicines used for cancer or other serious conditions — certain chemotherapy and immunosuppressive medicines can have kidney-related effects and require monitoring and dose adjustments. National Kidney Foundation
The important takeaway
Don’t stop a prescribed medicine simply because you’ve read that it can affect the kidneys. Some of these drugs—including ACE inhibitors, ARBs, and diuretics—are important treatments and can be beneficial when appropriately prescribed. The safest approach is to have your doctor or pharmacist review your complete medication list, including over-the-counter medicines and supplements. NIDDK+1
If you have kidney disease, medication doses may need to be adjusted according to your eGFR, and NSAIDs such as ibuprofen and naproxen generally deserve particular caution. National Kidney Foundation+1
