Misuse of certain drugs can have serious effects on kidney health, including acute kidney injury, chronic kidney disease, and, in severe cases, kidney failure. Recognizing warning signs early and getting help can reduce the risk of long-term harm.
At Sophros Recovery Jacksonville, our team offers specialized prescription drug addiction treatment that addresses both substance use and physical health risks. We create individualized plans that respect your goals and medical needs. To talk with a specialist, contact our team at 904.561.2947 or reach out online.
How drugs affect kidney function
Your kidneys regulate blood pressure, balance fluids and electrolytes, and support red blood cell production. When certain drugs affect the blood vessels that feed the kidneys, the result can be decreased blood flow, reduced kidney function, and even kidney failure. Early signs of kidney problems may include swelling, fatigue, changes in urination, high blood pressure, and nausea. If you have pre-existing kidney problems, diabetes, or heart failure, you face an increased risk.
The top 10 drugs commonly linked to kidney damage
The following list covers over-the-counter, prescription, and illegal drugs, and explains briefly how different drugs affect the kidneys through different mechanisms. This guide is educational only, not a diagnosis. Never stop a prescribed medicine without speaking with your doctor or clinician.
1. Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs, available over the counter and by prescription, can lower prostaglandins that keep blood vessels in the kidneys open. Reducing blood flow, especially at high doses or with dehydration, can cause acute renal failure or worsen chronic kidney disease. People with CKD, high blood pressure, or older adults are at higher risk. Learn more in the National Kidney Foundation’s article on pain medicines and kidney disease.
2. ACE inhibitors and ARBs
ACE inhibitors and ARBs treat high blood pressure and help regulate blood pressure within the kidney. These medicines often protect kidney tissue in kidney disease. However, they can bump creatinine levels up or contribute to acute kidney injury when combined with dehydration, diuretics, or NSAIDs. See how to use them safely in the NKF overview of ACE inhibitors and ARBs.
3. Opioids
Opioids can lead to kidney injury indirectly. Sedation and nausea may cause poor fluid intake, which reduces blood flow to the kidneys. In overdose or when combined with other depressants, low oxygen and low blood pressure increase the risk of acute kidney injury. Chronic opioid use may also complicate other conditions linked with kidney problems.
4. Antibiotics
Certain drugs used to treat bacterial infections, notably aminoglycosides like gentamicin and some dosing strategies of vancomycin, can injure renal cells in the renal tubules. Risk rises with high doses, prolonged courses, or when combined with other nephrotoxic agents.
5. Heroin
Heroin and other illegal drugs can trigger severe complications that cause kidney injury. Rhabdomyolysis, the rapid breakdown of muscle tissue, floods the bloodstream with myoglobin that clogs the urinary tract and damages kidney tissue, sometimes even causing kidney failure. Heroin use is also linked with infections and blood-borne viruses that worsen renal disease.
6. Lithium
Lithium is used to treat bipolar disorder and other mental health conditions. Over years, high blood levels can cause kidney dysfunction, including nephrogenic diabetes insipidus that impairs the kidneys’ ability to concentrate urine and, rarely, chronic kidney damage. Monitoring lithium levels and kidney function regularly with your prescriber lowers risk.
7. Chemotherapy drugs
Some chemotherapy drugs, such as cisplatin and high-dose methotrexate, are known for kidney toxicity. Cisplatin can injure kidney tissue and renal tubules and may lead to acute kidney injury. Hydration plans and close lab monitoring reduce risk, but kidney damage can be potentially irreversible.
8. Methamphetamines
Methamphetamines can cause hyperthermia, agitation, and muscle breakdown that lead to rhabdomyolysis, a medical condition where contents of damaged skeletal muscle tissue are released into the bloodstream. The release of muscle proteins burdens the kidneys and may lead to tissue inflammation and acute kidney injury. Severe spikes in blood pressure caused by methamphetamines can also stress the kidneys.
9. Cocaine
Cocaine constricts blood vessels and sharply raises blood pressure, which lowers blood flow to the kidneys. Complications include malignant hypertension, rhabdomyolysis, and thrombotic microangiopathy (a condition where blood clots in small blood vessels lead to blood cell destruction and, potentially, organ damage). These events can cause kidney injury and raise the risk of chronic kidney disease over time.
10. Antiviral drugs
Some antiviral medications are nephrotoxic at high doses or in dehydrated states. Acyclovir can form crystals inside the kidneys, which can block urine flow and irritate kidney tissue. Tenofovir, used for human immunodeficiency virus (HIV) and hepatitis B, can rarely cause proximal tubular dysfunction, so clinicians monitor renal function.
Other medicines and exposures to discuss with your clinician
- Proton pump inhibitors (PPIs): With long-term use, proton pump inhibitors have been linked in observational studies to acute kidney injury, acute interstitial nephritis, and possibly chronic kidney disease. People with CKD should avoid using OTC PPIs without medical advice. Review NKF guidance on proton pump inhibitors and CKD.
- Imaging contrast agents: Contrast-induced nephropathy can occur in people with CKD, diabetes, or dehydration. Hydration plans reduce risk.
- Herbal supplements: Certain herbal supplements can cause kidney toxicity, interact with medicines that regulate blood pressure, or worsen CKD. Aristolochic acid, found in some traditional products, can cause end stage renal disease. Learn about safer choices from NKF’s page on herbal supplements and kidney disease.
Who is at higher risk for drug-induced kidney damage?
Risk factors include older age, pre-existing kidney problems, diabetes, high blood pressure, dehydration, high doses or prolonged courses, and combining certain drugs; for example, ACE inhibitors with diuretics and NSAIDs. People with reduced kidney function should review all over-the-counter products with their care team.
Even if you are not at higher risk, always use the lowest effective dose of these medications for the shortest time possible. Stay hydrated, especially during illness, heat exposure, or when taking medicines that affect flow to the kidneys, and keep blood pressure and high blood sugar under control to protect kidney health.
Call your clinician promptly if you notice swelling in your legs or around your eyes, sudden weight gain, shortness of breath, decreased urine, foamy urine, severe fatigue, or persistent high blood pressure. These can signal kidney inflammation or reduced kidney function.
FAQs
What destroys the kidneys the most?
There is no single cause, but uncontrolled diabetes and high blood pressure account for most cases of chronic kidney disease worldwide. Among medicines, NSAIDs taken at high doses or for long periods, dehydration, and risky combinations can reduce blood flow to the kidneys and trigger injury. Illegal drugs like cocaine and methamphetamines can also cause severe, sudden kidney injury.
Which drug is highly toxic to the kidneys?
Several drugs have well-documented kidney toxicity at high doses or without monitoring, including chemotherapy drugs like cisplatin, certain antibiotics such as aminoglycosides, and antiviral drugs in specific situations. With medical oversight, many people can use these medicines safely when the benefits outweigh risks.
What is the name of the pill that stops kidney damage?
There is no single pill that prevents all kidney damage. Some medicines, like ACE inhibitors or ARBs, help protect kidney function and treat high blood pressure or albuminuria. However, these same medicines can increase the risk of acute kidney injury if you are dehydrated or taking NSAIDs, which is why individualized guidance matters.
Connect with an addiction specialist at Sophros Recovery Jacksonville today
Monitoring kidney function regularly is essential when you take medicines that can affect the kidneys. If a substance use disorder is part of your situation, we can help you reduce risks and move toward better health through outpatient addiction treatment for cocaine, heroin, or prescription drugs that can affect kidney function. Contact Sophros Recovery Jacksonville at 904.561.2947 to learn more.
Kidney damage risks can be lowered with proper care. We are here for individuals and families across Jacksonville and Northeast Florida with timely, compassionate care.
