“People with low levels of kidney function whose kidney disease is advanced have to be the most careful,” says consultant renal physician, Dr Donal O’Donoghue. “Most people with mild-to-moderate kidney disease who are otherwise healthy can safely take the same OTC remedies as the rest of the population.
“Whatever the stage of your kidney function, however, I’d always recommend talking to your pharmacist or doctor before taking OTC remedies so you can weigh up the risks and benefits.”
According to Dr O’Donoghue, you’re at higher risk of being harmed by certain OTC remedies if:
- you have advanced kidney disease (stage 4 or 5, or a kidney function below 30% of normal)
- you have mild-to-moderate kidney disease (stage 3 with a kidney function between 30 and 60% of normal) and are elderly with another serious illness, such as coronary heart disease.
Here is a list spelling out which OTC remedies are safe for you to use if you have kidney disease and which you should avoid. This is just a guide. For more detailed information, consult your pharmacist, renal specialist or GP.
Headaches
Paracetamol is safe and the best choice of painkiller to treat a headache. But avoid soluble products as they are high in sodium.
If your kidney function is less than about 50%, avoid painkillers containing aspirin, ibuprofen or similar drugs such as diclofenac (which has recently become available as Voltarol Pain-eze tablets). These products can deteriorate the function of damaged kidneys.
Low-dose aspirin of 75-150mg a day can be used if it's prescribed for the prevention of vascular disease. You should also avoid ibuprofen if you're taking anti-rejection treatment following a kidney transplant.
Coughs and colds
Many of the products available for coughs and colds contain a mixture of ingredients, so check the packaging carefully. Some products contain paracetamol, which is safe, but others contain high doses of aspirin, which it's best to avoid.
Many cold remedies also contain decongestants, which you should avoid if you have high blood pressure. The best way to clear congestion is by steam inhalation with menthol or eucalyptus. For coughs, try a simple linctus or glycerine honey and lemon to soothe your throat.
Muscle and joint pains
If you have muscle or joint pain, it's ideal to use skin creams and lotions such as Deep Heat, Ralgex and Tiger Balm, which you rub on to the painful area.
Avoid tablets containing ibuprofen or similar drugs such as diclofenac if your kidney function is below 50%.
Ibuleve (ibuprofen-containing) gel or spray is safer than ibuprofen tablets. But it isn’t completely risk-free, as a small amount of the drug penetrates your skin into the bloodstream.
Indigestion
For occasional treatment of indigestion, Gaviscon liquid or tablets are safe. Don't use Gaviscon Advance, however, as it contains potassium.
You can occasionally take Remegel and Rennie tablets, which contain calcium carbonate. But avoid aluminium- or magnesium-containing medicines, such as Aludrox or Maalox, unless they're prescribed by a renal doctor.
Ranitidine (Zantac), famotidine (Pepcid) and omeprazole (Losec) are safe to use for short-term relief of heartburn, but avoid cimetidine (Tagamet), as it can lead to a rise in the blood test for creatinine, making it seem as if your kidney function has got worse.
Hay fever and other allergies
Antihistamine tablets, nasal sprays and eye drops, including well-known brands such as Piriton (chlorpheniramine), Clarityn (loratadine) and Zirtek (cetirizine) are safe to take to relieve symptoms. Preparations containing sodium cromoglycate, such as Opticrom Eye Drops, are also safe.
Read more about antihistamines.
Complementary remedies
Homeopathic medicines are safe for kidney patients, but avoid herbal medicines because they can raise blood pressure. Some, such as St John’s wort, can interact with medicines prescribed for kidney disease. Others, such as echinacea, can directly affect kidney function.
Another problem is that different brands (and even different batches of the same brand) of herbal remedy can vary widely in terms of the amount of active ingredient they contain. This makes it difficult to predict how strong a dose will be.
