NSAIDs can pose a risk to your kidney health. But while acetaminophen may be safer, all pain medications should be taken with a doctor’s supervision if you have kidney disease.
It’s almost a reflex: You have an ache or pain, so you reach for an over-the-counter (OTC) pain medication. But as routine as this behavior is, not everyone should casually take pain medications, as there can be potential negative interactions.
For example, people with kidney damage or reduced kidney function might not be able to use every OTC pain medication. Let’s look at why and what you can safely do for pain relief.
Which pain medication is safest if you have kidney problems?
Before taking any pain medication, you should speak with your physician or a health professional to determine any possible interactions or risks that you might encounter.
For people with kidney disease, aspirin can increase the risk of bleeding. And in those with reduced kidney function, aspirin is not recommended unless prescribed by a physician. The recommended alternative can vary depending on the type and severity of kidney problems that you have.
Often, acetaminophen (Tylenol) is the preferred alternative. But it’s encouraged that you use the lowest dose possible that still manages pain or fever symptoms, decreasing doses gradually. And likewise, you should not exceed more than 3,000 milligrams per day.
Alternatively, if an OTC acetaminophen drug doesn’t control pain symptoms, a physician may suggest a temporary prescription alternative like tramadol. In its immediate release form, tramadol can be used in individuals with chronic kidney disease (CKD) or end stage renal disease (ESRD).
However, extended release dosing for tramadol is not recommended for people with advanced CKD or ESRD.
Which pain medication is safe for kidney transplant patients?
Similar to people with kidney disease, transplant recipients should only consider acetaminophen to manage post-operative pain symptoms. Again, best practices include using the lowest dose possible and never exceeding 3,000 milligrams per day.
Which pain medication is safe for kidney stones?
The short answer to this question is, it depends. If a patient has kidney stones with no underlying renal issues, then any OTC pain medication can be used to manage the pain symptoms associated with passing a kidney stone.
This includes ibuprofen, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen. Multiple studies and reviews have consistently shown positive patient outcomes when using OTC medications of all types to treat pain associated with renal colic or passing a kidney stone.
However, if someone also has impaired kidney function and kidney stones, NSAIDs are not recommended. A physician will provide the best guidance, but typically, sticking with acetaminophen is the best choiceTrusted Source for managing kidney stone pain when you have kidney disease or impaired kidney function.
Which pain medication can damage your kidneys?
Misusing any pain medication can increase your risk of kidney damage. This includes aspirin, ibuprofen, acetaminophen, NSAIDs, and of course, prescription opioid medications. The most common risks center around consuming too high a dose or taking medications for longer than recommended.
But of all the OTC pain medication categories, NSAIDs pose the greatest risk of continuous kidney damage. Specifically, these medications can increase the risk of progressive kidney damage or sudden kidney failure.
A 2019 studyTrusted Source involving over 764,000 U.S. Army officers found that participants who were prescribed more than seven daily doses of NSAIDs per month had an increase in the potential for an acute or chronic kidney disease diagnosis.
Takeaway
Regardless of whether you have a diagnosed kidney disorder or have healthy kidney function, OTC medications should be used with care.
Excessive use by consuming too high a dose or for prolonged periods can lead to a variety of health problems throughout your body — including damage to the kidneys.
For people with kidney disease or impaired kidney function, avoiding NSAIDs unless directed by a physician is the safest way to avoid further harm. Instead, opt for acetaminophen and be sure to use the lowest dose for the shortest period to control pain symptoms.
And when in doubt, speak with a physician or health professional before taking an OTC pain medication.
Melinda
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That’s the way to do it M. We have to educate and advocate or doctors will take years, maybe decades off our lives. I’ve been told many times there is no treatment for some of my health issues and within weeks, I’ve found a science and statistical study backed treatment that was successful. After decades of back pain and hundreds of doctor visits, I found a treatment for back pain that gave me relief within an hour and now pain free for 6 months. The only thing the doctors did was prescribe opioids which severely limited my life and I had to stop the drug treatment while still experiencing severe pain to avoid addiction and later withdrawal. My doctor prescribed NSAIDS in high doses to cover joint and muscle pain caused by statins. I then had a bleeding ulcer from the NSAIDS which required emergency surgery and months of rehabilitation. The doctor said I needed to take Proton Pump Inhibitor to offset the NSAIDS and this caused further complications that led to a neurological disorder. I stopped taking statins, NSAIDS, and PPIs and within weeks I was healthy again. Next, I managed my cholesterol by diet and exercise alone. Since I started the informed diet and exercise, my cholesterol has been within normal limits in spite of the impact CKD has on cholesterol. I could write an epic novel on how I successfully stopped doctors from killing me. I have 33 health issues some are fatal and some are secondary to CKD. I have 18 prescriptions. I only take 4 medications out of precautions for the most serious issues, and I manage all of the 33 health issues using diet and exercise and a few supplements for short periods. I still require several surgeries, that’s another story.
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It’s a constant issue for me because I have to balance my medication for my Bipolar Disorder and any interactions with medications along with the pain. I balance with knowledge and quality of life. I have learned you have to be as informed with supplements too because they can interact with medications and certain illnesses like Bipolar Disorder. The key for me is making informed decisions without playing doctor. I have shoulder surgery next. Take good care.
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You have the right attitude M. I know you have had to deal with a lot and you have done very well over the years and you sharing your journey and what you have learned along the way has helped everybody. Balance is the magic word.
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We all have our share! Hugs
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Indeed, we do. AS my hero Buzz Lightyear always says, “to infinite and beyond.” 🤗
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So true!
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A good article M. As a person with chronic kidney disease as a result of military doctors over-prescribing NSAIDS without follow-up and without taking action when blood tests began to show a plummeting eGFR, I have CKD. But, it doesn’t stop there. CKD also directly affects heart, lung, and thyroid health as well as the dreaded high LDL cholesterol. CKD also causes back pain and atherosclerosis, which leads to the widow maker, coronary artery disease. Doctors treat these ailments with a plethora of pills that need a plethora of more pills to counteract the vicious side effects. This often leads to the destruction of blood arteries and veins in the legs and low diastolic blood pressure and high systolic blood pressure along with a long list of unpleasant symptoms like hair loss, itching, random pain, cellulitis, and neuropathy, which needs several more pills recommended by the doctor. There are always different surgeries but the insurance won’t pay until it’s bad enough to severely reduce quality of life or be life threatening. What I describe is an ever downward health spiral that leads to long term suffering and it could all be prevented by avoiding pain medication and using alternate pain management. A healthy diet and moderate exercise is the miracle cure we all avoid. Some vegetables and spices when combined have the same effect as opioids but, without the mental impact or habit forming. Of course, for acute severe pain, the doctors are willing to sacrifice your longevity to give you immediate or short term relief with pain medications. You may agree with the doctor if your pain is intolerable. If I had taken charge of my health instead of rely solely on doctors I would be in perfect health and active with no dietary restrictions. While I agree totally with the article, I would add, be your own health activist. Do your part at home and then make sure the doctors understand your expectations. Don’t take medications just because the doctors prescribe it. They rarely consider drug interactions or a person’s individual tolerance for severe side effects. Before you agree to take a medication, study what this drug does and what it interacts with and what side effects you may experience. Also research which medications in a family of drugs is the most effective for your health status and has the least side effects. I can’t tell you how many times a doctor has prescribed a medication to me that I found out is lethal when combined with other medications I take or health issues I have. After ending up in the emergency room twice with life threatening conditions after a single dose of a new medication, I’ve learned to do my homework before I take anything. Rely on your doctor only after you have done an extensive review of your condition, how it’s treated. And what safe medications are out there in combination with your current health conditions and other prescriptions or supplements. Be safe and be your own health advocate. If your doctor dismisses your concerns, dismiss the doctor and find a real doctor. Long term suffering is not necessary. Avoid it.
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I also have CKD, Stage 3 and I balance this issue every day. My pain is high enough that the medication is needed but I don’t want to take pain pills so I take a medication with NSAIDS. It’s a mental thing, I don’t want NSAIDS or pain medication but living with high pain levels isn’t what I call a quality life. My Nephrologist tests my GFR several times a year. He would prefer I take Tramadol but it has a big downside as well. I don’t want to get addicted to any medication again. I’m fortunate that my kidneys have been stable. One thing I do before taking medication is read the Prescribing Instructions from the manufacturer. It provides all the info I need and much more so I can make an informed decision. I started advocating for my health a long time ago after having my doctor dismiss my questions.
How are you?????? You must be knee-deep because you haven’t written in some time. How is Tiger Mom getting along? I think of you often and hope life is giving you a few breaks. :)
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