Medicines that may affect kidney function
Reduce or stop then review
Dosage reduction or cessation of renally excreted medicines is generally required once GFR falls below 60 mL/min/1.73m2.1 It is important to review renally excreted medicines, as well as avoid medicines that can adversely affect kidney function.1
Medicines that may need reduced dose or stopping2
gliptins (saxagliptin, sitagliptin, vildagliptin)
Commonly prescribed medicines and agents that can adversely affect kidney function1
- NSAIDs and COX-2 inhibitors
Beware the ‘triple whammy’ of NSAID/COX-2 inhibitor, angiotensin converting enzyme inhibitor/angiotensin-II receptor blocker and diuretic (low dose aspirin is okay)
- Radiographic contrast agents
Note: The medicines discussed above do not include antibiotic, antifungal or antiviral medicines, or medicines predominately used in hospital.
- Kidney Health Australia. Chronic kidney disease (CKD) management in general practice. 2nd edition. 2012. www.kidney.org.au//LinkClick.aspx?fileticket=vfDcA4sEUMs%3d&tabid=635&mid=1584 (accessed 30 May 2013).
- Australian Government Department of Veterans' Affairs. Veterans' MATES Topic 30 - Renal impairment. March 2012. www.veteransmates.net.au/VeteransMATES/VeteransMATESServlet?page=site&m=10020 (accessed 18 June 2013).
- Patel AM, Shariff S, Bailey DG, et al. Statin toxicity from macrolide antibiotic coprescription: a population-based cohort study. Annals of Internal Medicine 2013;158:869-76. www.ncbi.nlm.nih.gov/pubmed/23778904
- Australian Medicines Handbook 2013. Adelaide: Australian Medicines Handbook Pty Ltd, 2013.