Your kidneys help retain the appropriate amount of fluid while eliminating waste from your body. They also contribute to the production of red blood cells and release hormones that regulate blood pressure. Thus, it’s crucial to know what allergy medicine is safe for kidney disease if you have both conditions.
Prescription and over-the-counter medications can accumulate in your blood when your kidneys aren’t functioning as they should. These could endanger other parts of your body or further harm your kidneys.
As a result, patients with chronic kidney disease (CKD) should learn which treatments are appropriate for them and which are not.¹
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Chronic kidney disease, commonly known as chronic kidney failure, is characterized by a progressive loss of kidney function. Your kidneys eliminate wastes and excess fluids from your blood via urine.
Around 37 million Americans are affected by kidney disease. When chronic kidney disease first develops, you may not have many signs or symptoms. It may go unnoticed until it’s pretty advanced.²
Advanced chronic kidney disease can lead to dangerously high fluid, electrolytes, and wastes in your body. This means the kidneys’ function will have to be done through dialysis. It is a treatment that uses a machine to filter and purify the blood. Although it cannot reverse kidney disease, it can extend your life.
If kidney damage proceeds slowly, signs and symptoms of chronic kidney disease emerge over time. Kidney failure can result in an accumulation of fluid or waste and electrolyte imbalances.
Depending on the severity, kidney function loss might result in the following signs and symptoms:
Swelling in the hands, legs, or feet
Itchy and dry skin
Shortness of breath due to fluid accumulation in the lungs
Foamy urine or blood in the urine
If fluid accumulates around the heart’s lining, it may cause chest pain
Hypertension, or difficult-to-control high blood pressure
Kidney disease symptoms are frequently nonspecific. This means that they can be caused by other illnesses as well. Because your kidneys can compensate for reduced function, you may not notice any symptoms until permanent damage has occurred.
The most prevalent causes of chronic kidney disease are diabetes and high blood pressure. The filters in your kidneys may be harmed by excessive glucose, often known as sugar.
When your blood sugar level is consistently high, your kidneys may suffer extensive damage over time, making it difficult to filter waste products and surplus fluid from your blood effectively. The medical name for kidney damage brought on by diabetes is diabetic kidney disease.
Kidney blood arteries can also be damaged by high blood pressure, affecting how well the kidneys function. If the blood vessels in your kidneys are damaged, your kidneys may be unable to eliminate wastes and excess fluid from your body effectively. A dangerous cycle may then be created by extra fluid in the blood vessels, further increasing blood pressure.
The risk of kidney impairment is determined by your health and the medicines you take.
Every medicine you take goes through your kidneys. If the medication is not taken as prescribed by your doctor, or if it is an illicit substance, it may harm your kidneys.
Nephrotoxic medications refer to drugs that can harm the kidneys. These medications can cause direct kidney injury. Some of these drugs negatively affect renal function, while others might cause acute kidney damage.³
An overreaction of the immune system causes allergies. The immune system defends the body against pathogens like viruses and bacteria that can lead to sickness. If you have allergies, your immune system reacts to an innocuous substance as if it were hazardous.
There are numerous forms of allergy medication, including pills, liquids, inhalers, nasal sprays, eyedrops, skin creams, and needles (injections). Some are available without a prescription, while others require one. These allergy medications include corticosteroids, combination medicines, decongestants, antihistamines, and others.
Many people ignore the dangers and adverse effects of medications, particularly if they don’t feel it applies to them. You might only be aware, for example, that some medications can harm your kidneys and other organs if you know how your kidneys are functioning.
The kidneys are responsible for filtering both prescribed and over-the-counter drugs. It follows that your kidneys eliminate and break down certain medications from your body.
A serum creatinine blood test can calculate your eGFR and reveal how well your kidneys are functioning. The eGFR measures how effectively your kidneys filter waste from your blood.
To ease allergy symptoms, antihistamine tablets (which target allergy cells in the body), including well-known brands like Piriton (chlorpheniramine) and Clarityn (loratadine), are generally safe to use.
Targeted eye drops and nasal sprays are also generally safe. Sodium cromoglycate-containing preparations, such as Opticrom Eye Drops, are likewise safe.
Below are some medications and substances you should avoid to prevent kidney damage:
Older decongestants such as diphenhydramine can lead to urinary retention, which can lead to kidney injury. If you must use a decongestant, try a nasal spray or drops.
However, if you use them for more than four days in a row, your nasal passages can thicken and absorb less of the medication. You can use saline nasal sprays as often as you like, as they are merely saltwater sprays.
When utilizing herbal products or complementary medications, those with kidney problems should exercise extreme caution.
Herbal treatments and products are not subject to the same regulations as pharmaceuticals. As a result, the ingredient listing may not always be correct, and some herbal remedies have been found to contain pesticides, hazardous plants, hormones, heavy metals, and other highly unsafe chemicals.
Some herbal treatments also contain diuretics, high levels of potassium, and other chemicals that can impact the kidneys or interact with your prescription prescriptions, causing them to lose effectiveness.
Vitamin C in high quantities (500 mg or more) is not advised. A multivitamin is specifically created for persons with kidney disease and has the required amount of vitamins for your kidneys. Inquire with your healthcare provider about this.
If you have kidney disease, be cautious of combination drugs that contain both an antihistamine and a decongestant, and always ask your doctor before taking them.
Many medications can disrupt kidney function and destroy the kidneys. If your kidneys are already not operating properly, medications might accumulate in your body.
When starting a new medicine, ask your doctor or pharmacist if it is safe to take with chronic kidney disease. You can safeguard your kidney health by maintaining an open line of contact with your doctor. All prescription, over-the-counter, and herbal drugs you plan to take should be discussed with your doctor or pharmacist first.
You are more prone to become tired after using first-generation antihistamines. Newer, second-generation antihistamines, such as loratadine (Claritin), have a lower risk of side effects. As a result, they are less prone to make you drowsy and are safe for kidney patients.
Cetirizine (Zyrtec) is primarily eliminated through the kidney; however, it is also partially metabolized in the liver. Patients with renal dysfunction may be more susceptible to cetirizine side effects due to poor medication clearance.
In patients six years of age and older with diminished renal function and impaired hepatic function, the manufacturer suggests a starting dose of 5 mg once a day.
Although Benadryl is not known to decrease kidney function, it has been documented (in very few case reports) to harm the kidneys in overdose situations or in those who already have a condition (e.g., bladder obstruction, urinary retention).
Certain medicines might cause renal failure if your kidneys are already impaired. Consult with your physician before taking allergy medications. In some situations, you can take a lower dose that is more suitable for you.
Kidney disease: The basics | National Kidney Foundation
Nephrotoxic medications (2022)
Chronic kidney disease | MSD Manual
Causes of chronic kidney disease | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
High blood pressure & kidney disease | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Estimated glomerular filtration rate (eGFR) | National Kidney Foundation