Why Pharmacists Ask About Kidney Problems Before You Take a Medicine
You are picking up a prescription when the pharmacist asks:
“Do you have any kidney problems?”
And for a moment you may wonder, What do my kidneys have to do with this bottle of tablets?
Quite a lot, depending on the medicine.
The question is not random, and your pharmacist is not attempting to complete your entire medical autobiography before you leave the counter. Kidney function can affect how some medicines move through and leave your body.
Your Kidneys Do More Than Make Urine
One of the kidneys’ many jobs is filtering the blood and helping remove waste products from the body.
They also help clear many medications and their breakdown products.
When kidney function is reduced, some medicines may leave the body more slowly. That can allow more medicine to remain in the body for longer than intended.
The National Kidney Foundation explains that some medications may therefore require a lower dose or a different dosing schedule when kidney function decreases. Read the National Kidney Foundation’s Medication Dosing and Kidney Disease guide
Notice the important word here: some.
Having kidney problems does not automatically mean every medication is unsafe or every dose must change.
It means kidney function is another piece of information your healthcare team may need when deciding whether a medication and its dose are appropriate.
Why Might the Pharmacist Ask?
The pharmacist may want to know whether you:
- have kidney disease
- have been told your kidney function is reduced
- receive dialysis
- have recently had a significant change in kidney function
- know a recent kidney-function result such as your eGFR
- take other medicines or products that could affect the kidneys
Some antibiotics, antivirals, pain medicines and other medications require particular attention when kidney function is reduced. The exact decision depends on the individual medicine and your circumstances.
This is why telling the pharmacist about your complete medication routine matters—including non-prescription products and supplements.
If the vitamin, herbal product or OTC medicine tends to mysteriously disappear from your medication list because “it isn’t really medicine,” have a look at Supplements Count Too: Why Your Pharmacist Needs the Full List.
Spoiler: it counts.
Even OTC Medicines Can Matter
A medicine being available without a prescription does not automatically make it suitable for everyone.
For example, certain nonsteroidal anti-inflammatory drugs (NSAIDs) can affect kidney function, particularly in some people with kidney disease or during situations such as dehydration. NIDDK recommends discussing prescription medicines, OTC medicines and supplements with your pharmacist when kidney health is a concern. See NIDDK’s Keeping Kidneys Safe: Smart Choices About Medicines
That does not mean you should suddenly stop medicines on your own.
Instead, ask.
The answer may be “yes, this is fine for you,” “we need to check something first,” or “there may be a better option.”
Help Your Pharmacist See the Full Picture
If you take several medicines, keeping an updated list can make these conversations much easier.
Include prescriptions, OTC products, vitamins, supplements, inhalers, creams, drops and medicines you use only occasionally.
The One-Bag Rule Before a Doctor Visit is one simple way to keep that information together.
And when collecting a new prescription, take a few seconds to review the medicine and directions before leaving. My guide, Check Before You Leave the Pharmacy, explains what to look for.
The Simple Takeaway
When your pharmacist asks about your kidneys, the question may sound unrelated to the medicine in your hand.
It isn’t.
For some medicines, kidney function can influence how quickly the medicine leaves your body and whether the dose or dosing interval needs adjustment.
So if you know you have kidney problems or have recently been told your kidney function has changed, mention it.
Sometimes the safest medication conversation begins with a question that seems completely unrelated.
“How are your kidneys?”
Turns out, they may have RSVP’d to the prescription discussion too.
Disclaimer
This article is for general health education only and is not medical advice. Kidney function, medication dosing and individual health needs vary. Do not start, stop or change the dose of a medication based on this article. Speak with your pharmacist, doctor or another qualified healthcare professional about your own medicines and kidney health.