What drugs must be avoided in Chronic kidney disease?
Whenever possible, nephrotoxic medications should be avoided including NSAIDs, which should be stopped when eGFR is <30 mL/min per 1.73m 2 and not prescribed long-term in patients with eGFR <60 mL/min per 1.73m 2 .
Other nephrotoxic medications are aminoglycosides, amphotericin, and cisplatin. The GFR level needs to be considered when dosing drugs that undergo kidney excretion, especially for such medications as lithium and digoxin.
Caution should be used when nutritional supplements are being used. Metformin should be discontinued in people with eGFR < 30 mL/min per 1.73m 2 .
Oral phosphate-containing bowel preparations (used for colonoscopy prep) should be avoided in people with an eGFR <60 mL/min per 1.73m 2 because of the risk of phosphate nephropathy.
