Guide to Over-the-Counter Medications for People ... - Michigan Medicine
Over-the-Counter (OTC) Medications for Patients with
Chronic Kidney Disease
Over-the-counter medications (OTC) are medications you can buy at the drug store or grocery store without a doctor's prescription to help relieve different symptoms. This guide will help you learn which medications you can safely take and which ones you should avoid.
Talk with your pharmacist to make sure these OTC medications are safe to take with your other prescribed medications.
Medications for pain, fever, or body aches
Okay to use: ? Acetaminophen (Tylenol). o Use as directed and do not take more than the maximum daily dose. o If you have liver disease, talk to your doctor first. o Many cold and flu medications contain acetaminophen, so it's important to check the labels for the dose.
Avoid: ? All non-steroidal anti-inflammatory drugs (NSAIDs). They can cause kidney injury and make high blood pressure worse. Common NSAIDs are ibuprofen (Advil, Motrin) and naproxen (Aleve). ? High doses of aspirin products, as they may cause kidney problems.
Medications for sneezing, itching, and runny nose
Okay to use: ? Antihistamines that cause the least amount of drowsiness: loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec). Department of Internal Medicine - 1 -
o A safe dose is 10 mg every 48 hours. o Talk to your doctor before using an antihistamine if you have
glaucoma, an enlarged prostate, or trouble urinating. Avoid:
? Allegra-D, Claritin-D, Zyrtec-D due to their effect on blood pressure. ? Combination (multi-symptom) cold, sinus, and flu products. It is better to
treat each symptom separately.
Medications for nasal (nose) and sinus congestion
Okay to use: ? Nasal saline o Nasal spray oxymetazoline (Afrin) should not be used for more than 3 days.
Avoid: ? Decongestants such as Sudafed or Sudafed PE. They can raise your blood pressure. ? Pseudoephedrine is not safe for kidney patients.
Medications for cough and chest congestion
Okay to use: ? Guaifenesin (Mucinex and Robitussin DM) for cough and chest congestion. ? The cough suppressant dextromethorphan (Delsym DM, Vicks Nyquil Cough Liquid). ? Coricidin Cold & Cough can help with a dry cough. ? Vicks VapoRub ointment and Vicks VapoSteam.
If you have diabetes, look for sugar-free and alcohol-free products.
Department of Internal Medicine
Over-the-Counter (OTC) Medications for Patients with Chronic Kidney Disease - 2 -
Medications for sore throat
Okay to use: ? Most throat lozenges (cough drops) are safe to use. o If you have diabetes, look for sugar-free products.
Medications for diarrhea
Okay to use: ? Loperamide (Imodium A-D). o Don't use for more than 48 hours.
Avoid: ? Kaopectate and Pepto Bismol, as they can cause kidney injury.
Contact your primary care doctor if your diarrhea is heavy, bloody, or lasts longer than 24 hours.
Medications for constipation
Okay to use: ? Psyillium (Metamucil). o Take other medications either 4 hours before or 2 hours after Metamucil). ? Docusate (Colace). ? Bisacodyl (Dulcolax). ? Polyethylene glycol (Miralax). o Drink a full glass of water with a dose of Miralax. You must stay well-hydrated for this medication to work. o Do not use if you are on fluid restrictions.
Avoid: ? Magnesium citrate. ? Magnesium hydroxide (Milk of Magnesia). ? Sodium phosphate enemas (Fleets).
Department of Internal Medicine
Over-the-Counter (OTC) Medications for Patients with Chronic Kidney Disease - 3 -
? Avoid using stimulant laxatives (medications that cause muscle movements in your bowels to push your stool/poop out) for longer than 1 week. Over time, they may cause dependence, can result in long-term diarrhea, and may cause changes in your electrolyte balance.
Call your doctor if you have any symptoms that do not improve in 2-3 days, or if you develop fever or chills.
Disclaimer: This document contains information and/or instructional materials developed by University of Michigan (U-M) Health for the typical patient with your condition. It may include links to online content that was not created by U-M Health and for which U-M Health does not
assume responsibility. It does not replace medical advice from your health care provider because your experience may differ from that of the typical patient. Talk to your health care provider if you have any questions about this document, your condition or your treatment
plan. Author: Roxy Black, BSN, RN, AMB-BC Reviewers: Emily Ashjian, RPh, Julie Wright, MD, Katie Clark, BSN, RN, Alison Chege, MSN, RN,
OCN Edited by: Brittany Batell, MPH MSW Patient Education by U-M Health is licensed under a Creative Commons AttributionNonCommercial-ShareAlike 4.0 International Public License. Last Revised 02/2023
Department of Internal Medicine
Over-the-Counter (OTC) Medications for Patients with Chronic Kidney Disease - 4 -
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