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Medication safety

Pain relief with kidney disease: avoid NSAIDs

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

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

Didascalia (pronta da incollare)

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?"

Fonti: 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
Verificato il: 2026-10-16

Schede e script sono informazione sanitaria generale tratta da linee guida cliniche pubbliche. Non sono consigli medici individuali e non sostituiscono la valutazione di medico, farmacista o dietista. Mantieni fonti e questa nota quando condividi; questa pagina contiene la versione più recente.
https://beyondckd.com/it/cards/painkillers-and-kidneys

Script video breve 60 s

Inquadrature e voce fuori campo. Verticale 9:16; sottotitoli nel terzo inferiore. Ogni frase rimanda alle fonti a sinistra.

s	Schermo	Voce
0–5	Hand reaching for painkillers on a pharmacy shelf	Headache, grab a painkiller? If you have kidney disease, wait a second.
5–17	Drug 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.
28–40	Three 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.
40–50	Sick 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.
50–60	Pharmacy counter speech bubble + site logo + QR	For 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.

Fonti (ogni punto della scheda vi corrisponde)

Verificato il: 2026-10-16