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What medicine harms the kidneys
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mysticalchevy posted:
Hi I have two healthy kidneys and a healthy liver. I take 150 mg. of Zoloft a day and two tablets of .25 mg of Alprazolam (or Zanax) a day for Obsessive Complusive Disorder. I talked to a nurse on the phone she said that taking the Zoloft is safe for your kidneys and your liver and it will not harm them. You can take Zoloft for your whole life if you need to and it will not harm them. She said that Zanax is a short term medicine and it can start to harm your kidneys after 5 years after taking it. I have only been on Zanax for 3 years. What medicines are bad for your kidneys and your liver? Are all medicines bad for your kidneys and your liver? My mom takes medicine for her high blood pressure, does this harm her kidneys or liver at all? Thanks for your help!
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John-SKPT responded:
Zoloft is metabolized largely in the liver, but apparently does not put any great load on the liver, at least in normal doses; almost none of it ends up in urine, so renal clearance of that drug is not a real concern. Xanax does pass through the kidneys but I can;t guess about the '5 year limit' that the nurse mentioned. There isn't a dose reduction mentioned for patients with renal disease, so you probably need to ask the doc who prescribed it about long term use. (Most drug studies don't track patients for more than 3 or 5 years, so there might not be good data on long term use.) It is metabolized in the small intestine by the cytochrome P450 3A4 enzyme, and this enzyme has a lot of drug interactions, and I'm sure you've read about the 'grapefruit juice' oddities that can affect some drugs: that's the cytochrome P450 3A4 matabolite pathway. So stay away from grapefruit and be cautious about taking any other drugs that suggest a 'grapefruit reaction'. Just be sure that ALL doctors know about everything that you are taking so that interactions can be minimized. Generally it is better to take blood pressure meds than not to take them, at least from the kidney point of view. Certain BP drugs, ACE inhibitors and Angioretensin Receptor Blockers are especially kidney friendly. People rarely think about over the counter drugs, but naproxen and ibuprofen are definitely NOT good for kidney health. An occasional Aleve or Advil won't hurt much but a lot of folks take these things 2 or 3 times a day for years and years and that can really be a problem. (Google "analgesic nephropahthy for more info). Tylenol/acetaminophen is safer for kidneys but can in very large doses stress the liver. Fewer medications is always the better way to go, but if a drug is needed, then everything else is a benefit vs. risk judgment from that point on. Most drug toxicities tend to be dose and time dependent, so taking at a recommended dose and for as short a duration as possible generally tends to be safer than taking high doses or for an extended period.
 
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mysticalchevy responded:
Thank you for your help John-SKPT! This is what I believe. Please let me know what you think about this. This helps me the most. There are medicines that are safe for long term usage that won?t harm the kidneys and the liver and some medicines that are not safe for long term usage that may harm the kidneys and the liver. Most drug toxicities tend to be dose and time dependent. Taking medicine at high doses and for extended periods is not safe for the kidneys and the liver. If I take something that is harmful for my kidneys and liver they will do blood tests to make sure that my kidneys and liver don't get to damaged. If I am taking medicine that is harming my kidneys and liver the doctor will reduce my dosage or take me off of that medicine if there is a better medicine for me. Your statement is a little confusing to me where it says "Fewer medications is always the better way to go, but if a drug is needed, then everything else is a benefit vs. risk judgment from that point on." "Most drug toxicities tend to be dose and time dependent, so taking at a recommended dose and for as short a duration as possible generally tends to be safer than taking high doses or for an extended period." Thank you!


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