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Over-the-counter (OTC) medicine and kidney disease

Over-the-counter medicine can easily be purchased at a pharmacy without a prescription. However, just because it’s readily available doesn’t mean it’s safe to use, especially if you are living with chronic kidney disease (CKD).

Most medication passes through the kidneys and if it isn’t used correctly, it can cause harm to the kidneys or interact with prescription medicine, changing its effectiveness. 

Elnette du Toit, pharmacy manager at Life West Coast Private Hospital, explains: ‘If you have CKD, the metabolism and excretion of the medication you’re taking could be altered. You always need to ask your pharmacist if the dose should be adjusted and if the medication is safe for a patient with CKD.’  

She believes there are five different types of over-the-counter (OTC) medicine of which you need to be wary.

1. Diuretics

Diuretics are any medicines that promote the expulsion of water and salt from your body. ‘These should be used with caution, as they help your body get rid of excess fluid,’ advises Elnette. ‘This reaction can sometimes cause you to dehydrate, which can be bad for your kidneys.’

2. Pain medication

Some over-the-counter medicine to relieve pain is not recommended because it can cause reduced blood flow to the kidneys, cautions Elnette. ‘Certain narcotic pain medication can build up and cause serious problems for people with renal failure.’

3. Non-steroidal anti-inflammatory drugs (NSAIDs)

Likewise, CKD sufferers need to be especially careful about NSAIDs. ‘They are widely used to relieve pain, reduce inflammation and bring down high temperature,’ asserts Elnette,' but this kind of medication has been associated with acute kidney injury in the general population and with progression of the disease in those with CKD.’ 

The only exception, she says, is aspirin, which is usually safe to use.

4. Antacids

Antacids are quick-relief medicines which regulate the acidity in your stomach. ‘Some antacid medication may disrupt the electrolyte balance of your body if you have kidney disease and so should be treated with caution,’ says Elnette.

5. Antimicrobials

Antimicrobials are medicines that kill microorganisms such as bacteria and fungi. The most common of these is antibiotics, which normally require a prescription. 

It’s best to treat antimicrobials with care, says Elnette. ‘Many antimicrobials are cleared by the kidney and dose adjustments should always be considered.’ 

Helpful hints for CKD patients taking OTC medicine:

  • Always buy prescription medication at one pharmacy, or find a Life Healthcare pharmacy near you, so your pharmacist can monitor your medication and supplements and check for harmful interactions between your medicines.
  • According to a 2016 National Institute of Health study, there is not enough evidence to indicate that the use of many alternative medications are safe when you have kidney disease. It’s safer to avoid these medications or consult your doctor before use.
  • If you are receiving treatment for diabetes as well as CKD, you may need to adjust the level of your diabetes medication, as this is also processed by your kidneys and your treating doctor will amend your prescription.

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided.