Before reaching for a pill in your medicine cabinet, you may want to consider the ill effects that it could have on your kidneys or your health. Many drugs including both prescription drugs and over-the-counter medications are eliminated from the body through the kidneys.
The kidney “clears” drugs based on their chemical structure and their effects on kidney function. You and your doctor may need to work together to adjust medication dosing and prevent adverse effects, including kidney damage.
Common medications that must be adjusted for kidney function include blood pressure medication, cholesterol medication, antibiotics, antiviral and pain medications. Heart medication, diabetes medication, gout medication, and insulin are all cleared by the kidney and may need dosage adjustments. If the dose is not adjusted, these medications can build up in your system and cause serious side effects or even further damage to your kidneys.
Drugs that can injure the kidney and reduce kidney function include non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, Motrin, Advil, Aleve, Naprosyn and Naproxen. These drugs directly decrease kidney function and, in some cases, can lead to kidney failure. If you have kidney disease, you should avoid NSAIDs. Certain stomach medications, known as proton pump inhibitors (PPIs), such as Omeprazole, Pantoprazole, and Lansoprazole, can cause damage to the kidney leading to chemical changes in the blood with loss of magnesium.
I recommend that you consider these five things when considering the pill you are about to take:
1. Kidney Function. It is important to know your level of kidney function when dosing medication. Your physician can calculate these measurements and this will lead to proper dosing of your medications. What is your age? Age alone can lead to a reduction in kidney function and must be considered.
2. Type of Medication. Your doctor will know which medications must be adjusted and which do not need adjusting. Your pharmacist will also know the adjustments that need to be made in medication dosing for your age and your kidney function.
3. Dosage. Always read the labels of both prescription medication and over-the-counter medication. Bottles of medications may look similar and you need to be sure the dose on the label is the dose you should be taking. If your pharmacy has changed the pill or it is a new generic that you are taking, make sure the dose is the same as had been recommended for you.
4. Length of Use. If you have been taking a medication for a long time, you may need to review the dose with your physician or your pharmacist to make sure it is still the proper dose. Long term use of NSAIDs can cause damage to even normal kidneys.
5. Drug interactions. The more pills you take, the more they may interact with each other and cause harm to you or your kidneys. Even over-the-counter medications and herbal medications can have drug interactions with prescription drugs and cause harm and injury. Your physician and your pharmacist should know all the pills you are taking and review them together to make sure that drug interactions are considered.
To learn more about kidney disease, visit www.kidney.org.