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Pharmacy remedies and kidney disease

Some remedies are potentially harmful for people with kidney disease. Make sure you check with a doctor or pharmacist before taking a new over-the-counter medicine.

Here's a list of over-the-counter remedies that are safe to use if you have kidney disease, and those you should avoid.

This is just a guide. For more detailed information and advice, consult a pharmacist, renal specialist or GP.

What's safe

Paracetamol is safe and the best choice of painkiller to treat a headache. But avoid soluble paracetamol products as they're high in sodium.

What to avoid

If your kidney function is less than 50%, avoid painkillers containing aspirin or ibuprofen (unless a doctor specifically prescribes them for you).

They can worsen the function of damaged kidneys. Ibuprofen should also be avoided if you're taking anti-rejection medicines after a kidney transplant.

Low-dose aspirin of 75 to 150 milligrams (mg) a day can be used if it's prescribed for the prevention of vascular disease.

Many of the products available for coughs and colds contain a mixture of ingredients, so check the packaging carefully.

What's safe

Any product that contains only paracetamol as the active ingredient.

What to avoid

Some cough and cold remedies contain high doses of aspirin, which it's best to avoid.

Many cold remedies also contain decongestants, such as pseudoephedrine, which you should avoid if you have high blood pressure.

What's safe

If you have muscle or joint pain, it's best to use skin creams and lotions such as Deep Heat, Ralgex and Tiger Balm, which you rub onto the painful area.

What to avoid

Avoid tablets containing ibuprofen or diclofenac if your kidney function is below 50%.

Ibuleve (ibuprofen-containing) gel or spray is safer than ibuprofen tablets. But it is not completely risk-free, as a small amount of the medicine penetrates your skin and goes into the bloodstream.

What's safe

For occasional treatment of indigestion, Gaviscon liquid or tablets are safe, as are Remegel and Rennie tablets, which contain calcium carbonate.

What to avoid

Do not use Gaviscon Advance to treat indigestion as it contains potassium.

Avoid medicines that contain aluminium or magnesium, such as Aludrox or Maalox, unless they're prescribed by a renal doctor.

What's safe

Famotidine (Pepcid) and omeprazole (Losec) are safe to use for the short-term relief of heartburn.

What to avoid

Avoid cimetidine (Tagamet) for heartburn because it can lead to a rise in creatinine levels in the blood, making it seem as if your kidney function has worsened.

What's safe

Antihistamine tablets, nasal sprays and eyedrops, including well-known brands such as Piriton (chlorpheniramine) and Clarityn (loratadine), are safe to take to relieve allergy symptoms.

Preparations containing sodium cromoglycate, such as Opticrom Eye Drops, are also safe.

If you use Zirtek (cetirizine) and your kidney function is below 50%, you'll need to reduce the dose you take, only take it every other day, or avoid it altogether. A doctor or pharmacist can advise you.

Read more about antihistamines.

What's safe

Any vitamin preparation that does not contain vitamin A is safe to use.

What to avoid

Avoid multivitamins containing vitamin A as it can build up in your body and be harmful. If your kidneys are damaged, they can have problems clearing it.

Effervescent vitamin tablets can contain up to 1g of salt per tablet. Switch to a non-effervescent tablet if you've been advised to watch or reduce your salt intake.

What's safe

Senna tablets or liquid are safe to use if you have kidney disease and you're constipated.

Speak to a GP if you continue to have constipation after taking senna and making some simple lifestyle changes.

What to avoid

Fybogel only works if you drink a lot, so it's not suitable for people with kidney disease.

What's safe

You can use liquid loperamide (Imodium) to treat diarrhoea.

See a doctor or pharmacist for advice if you have diarrhoea and vomiting and kidney problems.

Avoid herbal medicines if you have kidney disease as they can raise blood pressure.

Some, such as St John's Wort (for low mood), can interact with medicines prescribed for kidney disease.

Others, such as echinacea (used as a cold and flu remedy), can directly affect kidney function, so you should get advice from your doctor or pharmacist before using them.

Another problem is that different brands (and even different batches of the same brand) of herbal remedy can vary widely in the amount of active ingredient they contain. This makes it difficult to predict how strong a dose will be.

Read more about how your pharmacist can advise you about over-the-counter medicines and kidney disease.