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MEDICATION SAFETYPain relief with kidneydisease: avoid NSAIDs1Common NSAIDs: ibuprofen, diclofenac, naproxen,mefenamic acid, celecoxib, and aspirin at pain-reliefdoses. Many combination cold remedies contain themtoo.2KDIGO guidance: avoid NSAIDs when eGFR is below 30;no prolonged use when eGFR is below 60.3The "triple whammy": an NSAID plus an ACEinhibitor/ARB plus a diuretic clearly raises the riskof acute kidney injury.4Risk is higher when you are ill and dehydrated(vomiting, diarrhoea, fever) — ask your doctor whichmedicines to pause on sick days.5For occasional pain, acetaminophen (paracetamol)within the recommended dose is usually the saferchoice — but still ask first; patches and gels areabsorbed too.Before buying any painkiller, ask the pharmacist one question: "I havekidney disease — is this safe for me?"BBeyond CKDbeyondckd.com/en/cards/painkillers-and-kidneysSources: KDIGO 2024 CKD Guideline · KDIGO 2012 CKD Guideline · 2026-10-16Compiled from public clinical guidelines · General education, not individual medical advice
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Medication safety

Pain relief with kidney disease: avoid NSAIDs

Headache — grab any painkiller? With kidney disease, check which kind first.

  1. 1Common NSAIDs: ibuprofen, diclofenac, naproxen, mefenamic acid, celecoxib, and aspirin at pain-relief doses. Many combination cold remedies contain them too.
  2. 2KDIGO guidance: avoid NSAIDs when eGFR is below 30; no prolonged use when eGFR is below 60.
  3. 3The "triple whammy": an NSAID plus an ACE inhibitor/ARB plus a diuretic clearly raises the risk of acute kidney injury.
  4. 4Risk is higher when you are ill and dehydrated (vomiting, diarrhoea, fever) — ask your doctor which medicines to pause on sick days.
  5. 5For occasional pain, acetaminophen (paracetamol) within the recommended dose is usually the safer choice — but still ask first; patches and gels are absorbed too.

Before buying any painkiller, ask the pharmacist one question: "I have kidney disease — is this safe for me?"

Caption (ready to paste)

Headache — grab any painkiller? With kidney disease, check which kind first.

1. Common NSAIDs: ibuprofen, diclofenac, naproxen, mefenamic acid, celecoxib, and aspirin at pain-relief doses. Many combination cold remedies contain them too.
2. KDIGO guidance: avoid NSAIDs when eGFR is below 30; no prolonged use when eGFR is below 60.
3. The "triple whammy": an NSAID plus an ACE inhibitor/ARB plus a diuretic clearly raises the risk of acute kidney injury.
4. Risk is higher when you are ill and dehydrated (vomiting, diarrhoea, fever) — ask your doctor which medicines to pause on sick days.
5. For occasional pain, acetaminophen (paracetamol) within the recommended dose is usually the safer choice — but still ask first; patches and gels are absorbed too.

Before buying any painkiller, ask the pharmacist one question: "I have kidney disease — is this safe for me?"

Sources: KDIGO 2024 CKD Guideline — Ch. 4 (medication safety, NSAIDs, sick-day guidance); KDIGO 2012 CKD Guideline — Rec. 4.4 (NSAIDs: avoid at GFR <30; no prolonged use at GFR <60); Lapi F et al. NSAIDs + diuretics + ACEi/ARB and acute kidney injury — BMJ 2013;346:e8525; NKF — Pain Medicines (Analgesics) and the kidneys
Verified: 2026-10-16

Cards and scripts are general health education compiled from public clinical guidelines. They are not individual medical advice and do not replace assessment by your doctor, pharmacist or dietitian. Please keep the sources and this notice when sharing; this page holds the latest version.
https://beyondckd.com/en/cards/painkillers-and-kidneys
60-second short-video script

Shot list and voice-over. Vertical 9:16; put captions in the lower third. Every line maps to the sources on the left.

secScreenVoice-over
0–5Hand reaching for painkillers on a pharmacy shelfHeadache, grab a painkiller? If you have kidney disease, wait a second.
5–17Drug list: ibuprofen, diclofenac, naproxen…Many common painkillers are NSAIDs — ibuprofen, diclofenac, naproxen — and plenty of cold remedies contain them. They reduce blood flow to the kidneys.
17–28"eGFR <30 avoid | <60 no long-term use"KDIGO guidelines say: avoid NSAIDs if eGFR is below 30, and no long-term use below 60.
28–40Three pills colliding: NSAID + ACEi/ARB + diuretic → ⚠️Watch out for the triple whammy: an NSAID plus a blood-pressure drug like an ACE inhibitor or ARB, plus a diuretic — acute kidney injury risk goes up clearly.
40–50Sick person icon, "ask your doctor"The risk is higher when you are ill and dehydrated. Vomiting, diarrhoea, fever — ask your doctor which medicines to pause.
50–60Pharmacy counter speech bubble + site logo + QRFor occasional pain, acetaminophen within the recommended dose is usually safer. But always ask: I have kidney disease — is this OK for me? More at Beyond CKD.

Sources (every point on the card maps to one)

Verified: 2026-10-16