Managing Medications

People with chronic kidney disease often need to take multiple medications. Understanding the medications that have been prescribed to you is a key part of taking an active role in managing your kidney disease. 

Because your kidneys are responsible for removing medications from your body, as your kidney function changes your medications will also change.  Eventually you may need to decrease the amount you take of certain drugs, take them less often, or you may stop taking them altogether.  New medications may be prescribed. 

It’s very important to take your medications exactly as prescribed, or they may be less effective.  Some drugs are meant to be taken a specific number of times per day.  Some need to be taken with food, and some on an empty stomach. Never stop taking a drug without talking to your doctor first.

You should maintain an up-to-date list of all the medications you’re taking and bring it with you to every appointment and emergency room visit.  Also let your pharmacist know that you have chronic kidney disease. 

Finally, when you have chronic kidney disease, it’s very important to check with your doctor before taking any over-the-counter medications.  NSAIDS (non-steroidal anti-inflammatory drugs) like ibuprofen (Advil, Motrin) or naproxen (Aleve) can cause damage to the kidneys, especially if used at a high dose for long periods of time.  Vitamins, laxatives, antacids, and herbal medicines all need to be approved by your doctor, because they can affect your kidneys and/or the effectiveness of the medications you’re taking.

Five Tips for Kidney Patients to Treat the Common Cold and Flu

​Each year millions of Canadians suffer from the common cold and winter flu; individuals living with kidney disease are no exception. Prevention is the best medicine. Having an annual flu shot, and washing your hands frequently are the best lines of defense. It is also recommended that all people with chronic kidney disease have the pneumococcal vaccine to prevent severe forms of pneumonia. 

COVID-19 and the flu can have similar symptoms. If you start to develop flu like symptoms, Health Canada recommends following the same precautions taken for COVID-19.

If despite your best efforts, you are feeling the symptoms of the common cold or flu, the following tips may help you treat the symptoms.  While many medications are good for your kidney health, some medications can put you at risk of further kidney damage or may build up in your body causing undesirable effects.

1. For most people with kidney disease, acetaminophen (Tylenol®) is safe to use for headache, pain and fever. Speak to your physician or pharmacist to see if acetaminophen is suitable for you.

2. Cold and flu medications that contain decongestants may increase blood pressure. Avoid cough and cold medications that contain ASA or NSAIDs (Non-steroidal anti-inflammatory medications) such as ibuprofen (Advil®, Motrin®) or naproxen (Aleve®). If you have to use a decongestant, use a nasal spray or nasal drops. (Note: Some of these nasal sprays that are available over the counter, such as Otrivin®, can be habit forming. If you use them more than four days in a row, the blood vessels in your nose can become dependent on the spray). Saline nasal sprays (Salinex®, Hydrasense®) are safe for use.

3. Sore throat? Many cough syrups and throat lozenges contain sugar. Make sure you read the label to check the ingredients list, prior to use. Some sugar free or sucrose-free products are available on the market (Ricola® SUGAR FREE or Bentasil® SUGAR-FREE). Gargling with salt water may also be an effective way to soothe a sore throat.

4. ​Avoid herbal remedies. People living with kidney disease should use extreme caution when using herbal products or complimentary medicines. Herbal medications and products are not regulated in the same way that pharmaceutical products are. Therefore, the list of ingredients is not always accurate and some herbal medicines have been found to contain pesticides, poisonous plants, hormones, heavy metals and other compounds that are potentially dangerous. Some herbal medications also include diuretics, high levels of potassium, and/or other ingredients that can affect the kidneys or interact with your prescription medications to change their effectiveness.

5. Vitamin C is not the answer.  High doses of vitamin C (500 mg or more) are not recommended. There is a specially formulated multivitamin, Replavite®, for people with kidney disease that has the right amount of vitamins that your kidneys can handle. Ask your healthcare team about this.

Questions?  Your pharmacist and members of your kidney health team are the best source of information. Ensure you read the label, even on over the counter medications that you’ve taken before, as ingredients do change from time to time. If you have severe symptoms (like shortness of breath, high fever, coughing blood), please contact or see your healthcare provider.  


Source: www.kidney.ca, The Kidney Foundation of Canada, Living with Reduced Kidney Function (Chapter 4)
Reviewed By:  Parmjot Rehal, RPh ACPR BScPhm