Eight pills you shouldn’t take because they damage your kidneys

8 Medicines That Can Harm the Kidneys — and What to Know

The headline “never take these pills” is too absolute. Many medicines can affect kidney function, but the risk depends on the drug, dose, duration, dehydration, other medications, and your existing kidney health. Don’t stop a prescribed medicine without speaking with your doctor or pharmacist.

Eight important examples are:

1. Ibuprofen and other NSAIDs
   NSAIDs can reduce blood flow to the kidneys and, particularly at high doses or during dehydration, can cause acute kidney injury. Examples include ibuprofen and naproxen.

2. Diclofenac
   This is also an NSAID and carries similar kidney-related risks, particularly with prolonged use or in people who already have kidney problems.

3. Ketorolac
   Another NSAID that can affect kidney blood flow. It is generally intended for short-term use and requires particular caution in people at higher risk of kidney injury.

4. Certain antibiotics
   Some antibiotics, including aminoglycosides such as gentamicin, can be nephrotoxic. They are generally used with appropriate monitoring when necessary.

5. Vancomycin
   This antibiotic can cause kidney injury, particularly with higher exposures or when combined with other nephrotoxic medicines, so clinicians may monitor kidney function and drug levels when appropriate.

6. Some antiviral medicines
   Certain antivirals can affect the kidneys, particularly in people with impaired kidney function or when dosing isn’t appropriately adjusted.

7. Lithium
   Long-term lithium treatment can affect kidney function in some people. Those taking it generally need periodic monitoring rather than simply discontinuing it.

8. Some proton-pump inhibitors (PPIs)
   Medicines such as omeprazole are widely used and generally safe for most people, but long-term PPI use has been associated with certain kidney problems. They should be used at the appropriate dose and duration.

⚠️ The Bigger Risk: Drug Combinations + Dehydration

Kidney injury is sometimes caused not by one medicine alone but by a combination of factors. For example, an NSAID + certain blood-pressure medicines + a diuretic, particularly when someone is dehydrated, can substantially increase the risk of acute kidney injury.

Older adults and people with chronic kidney disease, heart failure, diabetes, or dehydration may be particularly vulnerable.

What You Should Do

Don’t automatically avoid these medications. If they’re prescribed, ask:

• Is this dose appropriate for my kidney function?

• Do I need a blood test to monitor my kidneys?

• Can I safely take it with my other medicines?

• How long should I take it?

For over-the-counter pain relief, check with a pharmacist before regularly taking NSAIDs if you have kidney disease or take multiple medications.

Bottom line: The important message isn’t “eight pills are forbidden.” It’s that some medicines can injure the kidneys under certain circumstances, and medication choice and dosing should take kidney function into account.