Medicines to avoid
Many medicines are wholly or in part removed from the body by the kidneys. So it makes sense for everyone with ADPKD to avoid any medicines that could harm the kidneys or make other treatments less effective. This applies not only to medicines prescribed by a doctor or in hospital, but also to remedies you buy over the counter from the pharmacist or supermarket.
If your kidney function is reduced, you may need to take lower doses of some medicines. So always check with your own doctor if you are doubtful about any medicine that has been prescribed for you.
Talk to your doctor or pharmacist before taking any over-the-counter remedies and supplements. These medicines may be harmful to your kidneys or may interfere with or affect the effectiveness of other medicines you are taking.
Always read the patient information leaflet (PIL) inside the medicine pack. This will tell you whether the medicine may cause you problems if you have kidney disease. If you cannot find the PIL you can download a copy at the eMC website.
Get to know the generic or scientific names of your medicines. Many medicines have two names on the package: the brand or proprietary name (e.g. Panadol) and the generic name (e.g. paracetamol). There may be two or more brands of a medicine, but while brand names differ, the generic name is always the same, and is usually printed under the brand name on the package. Knowing the generic name will help you to make sure you are given the right medicine at the pharmacists, and that it is safe for you to buy the medicine over the counter.
Never buy medicines from a website unless it is the website of a trusted pharmacy. Many medicines available without a prescription over the internet are fake or contain harmful substances.
People with ADPKD should avoid taking the following medicines unless your doctor has prescribed them or given you the go-ahead to take them.
Non-steroidal anti-inflammatory drugs (NSAIDs)
There are two types of NSAIDS, but both are bad for your kidneys because they raise your blood pressure:
- Non-selective NSAIDs, such as ibuprofen, diclofenac, naproxen, indomethacin, and mefenamic acid. Ibuprofen and mefenamic acid can be bought over the counter.
- COX-2 inhibitors or selective NSAIDs, such as celecoxib and etoricoxib. These are sometimes prescribed because they are less likely to cause stomach problems than non-selective NSAIDs.
Aspirin may harm your kidneys when taken in a dose that is high enough to control pain (above 300 mg each day). Your doctor may suggest that you take a low-dose aspirin (up to 150 mg) each day as this may help to protect your heart.
Ephedrine is included in some over-the-counter remedies for coughs and colds, and in diet pills you can buy from a pharmacy or herbalist. You should avoid ephedrine because it pushes up your heart rate and blood pressure, possibly damaging your kidneys and increasing your risk of heart disease and strokes.
Chinese/herbal medicines and vitamin supplements
Chinese/herbal medicines and vitamin supplements have not usually been studied in people with kidney disease, so there is no way of knowing whether they are safe for you to use. Modern drugs go through rigorous tests of their effectiveness and purity. But some Chinese and herbal remedies have been found to contain substances that may cause kidney failure and cancer, while others contain substances that interfere with the effectiveness of your other medicines.