General Warnings

Top 10 Drugs That Cause Kidney Damage

Drugs can cause acute renal injury, intrarenal obstruction, interstitial nephritis, nephrotic syndrome, and acid-base and fluid electrolytes disorders. Certain drugs can cause alteration in intraglomerular hemodynamics, inflammatory changes in renal tubular cells, leading to acute kidney injury and renal scarring.

Medications are a relatively common cause of acute kidney injury, especially in hospitalized patients who are exposed to numerous agents. Drug-related acute tubular/tubulointerstitial injury is the most common cause of AKI associated with these agents. The toxic effects of drugs and their renal handling often lead to various forms of AKI.

Prospective cohort studies of AKI have documented the frequency of drug-induced nephrotoxicity to be approximately 14-26% in adult populations. Nephrotoxicity is also  a significant concern in pediatrics with 16% of hospitalized AKI events being attributable primarily to a drug .

Top 10 Drugs That Cause Kidney Damage

What are the top 10 drugs that cause kidney damage?

There are several drugs that can cause liver damage from over the counter medication to prescription medicines. The table below provides a full list of all medications that can damage your kidney:

Acetaminophen, aspirinChronic interstitial nephritis
Nonsteroidal anti-inflammatory drugsAcute interstitial nephritis, altered intraglomerular hemodynamics, chronic interstitial nephritis, glomerulonephritis
Antidepressants/mood stabilizers
Amitriptyline (Elavil*), doxepin (Zonalon), fluoxetine (Prozac)Rhabdomyolysis
LithiumChronic interstitial nephritis, glomerulonephritis, rhabdomyolysis
Diphenhydramine (Benadryl), doxylamine (Unisom)Rhabdomyolysis
Acyclovir (Zovirax)Acute interstitial nephritis, crystal nephropathy
AminoglycosidesTubular cell toxicity
Amphotericin B (Fungizone*; deoxycholic acid formulation more so than the lipid formulation)Tubular cell toxicity
Beta lactams (penicillins, cephalosporins)Acute interstitial nephritis, glomerulonephritis (ampicillin, penicillin)
Foscarnet (Foscavir)Crystal nephropathy, tubular cell toxicity
Ganciclovir (Cytovene)Crystal nephropathy
Pentamidine (Pentam)Tubular cell toxicity
QuinolonesAcute interstitial nephritis, crystal nephropathy (ciprofloxacin [Cipro])
Rifampin (Rifadin)Acute interstitial nephritis
SulfonamidesAcute interstitial nephritis, crystal nephropathy
Vancomycin (Vancocin)Acute interstitial nephritis
Adefovir (Hepsera), cidofovir (Vistide), tenofovir (Viread)Tubular cell toxicity
Indinavir (Crixivan)Acute interstitial nephritis, crystal nephropathy
Calcineurin inhibitors
Cyclosporine (Neoral)Altered intraglomerular hemodynamics, chronic interstitial nephritis, thrombotic microangiopathy
Tacrolimus (Prograf)Altered intraglomerular hemodynamics
Cardiovascular agents
Angiotensin-converting enzyme inhibitors, angiotensin receptor blockersAltered intraglomerular hemodynamics
Clopidogrel (Plavix), ticlopidine (Ticlid)Thrombotic microangiopathy
Carmustine (Gliadel), semustine (investigational)Chronic interstitial nephritis
Cisplatin (Platinol)Chronic interstitial nephritis, tubular cell toxicity
Interferon-alfa (Intron A)Glomerulonephritis
MethotrexateCrystal nephropathy
Mitomycin-C (Mutamycin)Thrombotic microangiopathy
Contrast dyeTubular cell toxicity
Loops, thiazidesAcute interstitial nephritis
Triamterene (Dyrenium)Crystal nephropathy
Drugs of abuse
Cocaine, heroin, ketamine (Ketalar), methadone, methamphetamineRhabdomyolysis
Chinese herbals with aristocholic acidChronic interstitial nephritis
Proton pump inhibitors
Lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix)Acute interstitial nephritis
Allopurinol (Zyloprim)Acute interstitial nephritis
Gold therapyGlomerulonephritis
Haloperidol (Haldol)Rhabdomyolysis
Pamidronate (Aredia)Glomerulonephritis
Phenytoin (Dilantin)Acute interstitial nephritis
Quinine (Qualaquin)Thrombotic microangiopathy
Ranitidine (Zantac)Acute interstitial nephritis
Zoledronate (Zometa)Tubular cell toxicity

Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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