Using Over-the-Counter Medicines When You Have Kidney Disease

Because your child has kidney disease, it is important for you to know how to safely give them over-the-counter medicines, herbal and nutritional supplements and vitamins. Check with your healthcare provider before giving any type of medicine or supplement to your child. Having kidney disease can put your child at higher risk for having a bad reaction to these products. There is no way to cover all the different products available, but these tips should help you decide what is safe.

• Read the warning label for any over-the-counter medicines. Avoid medicines that say to use with caution if you have high blood pressure or kidney disease.
• Look for a list of active ingredients on the label to see which medicines are found in the product. Many products have more than one medicine.
• Keep a list of all your child’s medicines, including over-the-counter vitamins and herbal supplements. Bring this list to your child’s clinic visits. Better yet, bring all your child’s medicines, herbal supplements and vitamins to the visit.
• Let your child’s doctor know all of the over-the-counter medicines, herbal supplements and vitamins they are taking. Some of these products are not dangerous by themselves but may interact with your child’s prescribed medicine and should not be used.
• Just because something is labeled as “natural” does not mean it is safe!
• Check with your healthcare provider or pharmacist if you have any questions or concerns.

All pain medicines should be used at the lowest amount (dose) and for the shortest time possible. Long-term use at high doses can harm even normal kidneys. If your child is taking pain medicines, be sure to increase the amount of liquids they drink. If your child needs to take them for more than 10 days, see your child’s doctor. Avoid pain medicines that have caffeine in them, such as Excedrin; they may increase your child’s blood pressure.

A good pain medicine choice for people with kidney problems is acetaminophen (Tylenol), if recommended by your child’s healthcare provider. Take it with a full glass of water. We do not recommend Ibuprofen (Advil), naproxen (Aleve) and aspirin (Bayer). If your child needs to use these medicines, it should be monitored by your child’s healthcare provider.

It is best for your child not to take decongestants. Decongestants are often found in cold medicines. An example is pseudoephedrine (Sudafed). These can raise blood pressure. If your child needs a decongestant, a saline nasal spray or vapor rub can be used safely.

Decongestants can also be found in cough suppressants. It is best not to take these. If recommended by your child’s healthcare provider, it is fairly safe to use a cough suppressant if dextromethorphan is the only ingredient or an expectorant (guaifenesin) that loosens mucus.

Antacids may contain aluminum, magnesium, sodium bicarbonate or calcium. Check with your healthcare provider to see if these are safe for your child.

Avoid laxatives with magnesium. Be sure your child drinks a lot of liquids if they are taking other laxatives.

Talk to your child’s healthcare provider before they take any vitamins. Some vitamins should not be taken with kidney disease.

Some herbs are dangerous for people with kidney problems. Since they are not regulated the same as medicines, it can be hard to know what is in a product. Always check with your child’s healthcare provider or pharmacist before they take any herbs.

The ingredients in Chinese herbs are often not listed. It is hard to know what you are taking. Some cause severe kidney disease. For example, aristolochic acid is toxic to the kidney. Other herbs that should be avoided include:

• Asparagus root
• Ma huang
• Birch root
• Quercetin
• Chromium
• Yohimbine

Check with your child’s healthcare provider if they are considering nutritional supplements.

Illegal substances should not be used because they can cause harm to the body including the kidneys. If your child or someone else you love has a substance abuse problem, please seek help. You can find more information by visiting the Substance Abuse and Mental Health Services Administration Web site at
samhsa.gov.