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Most prescription drugs are excreted by the kidneys. So are many of the medications you buy over the counter. Whether or not you have decreased kidney function, it’s important to speak with

your doctors and pharmacist about what medications you’re taking, how much you’re taking and how often you’re taking them. Doses may have to be adjusted to prevent adverse effects, toxicity

and increased damage to your kidneys. Steven Coca, professor of medicine and a nephrologist at the Icahn School of Medicine at Mount Sinai in New York, says you should know your estimated

glomerular filtration rate (eGFR), the primary measurement of kidney function, and your urine albumin to creatinine ratio (UACR), a marker of kidney damage. Your eGFR will show up any time

your doctor orders standard blood work, which is usually covered by insurance. It’s part of the most basic generic lab work you can get. Your UACR test, also usually covered by insurance, at

least in part, indicates the level of protein in your urine and is normally given once a year to monitor kidney damage for those with kidney disease. The UACR also monitors the kidneys for

patients who’ve had type 1 diabetes for five years or more and for patients with type 2 diabetes.   “You ought to know these numbers because chronic kidney disease is one of the strongest

risk factors for cardiovascular disease and because many medications that are taken by older people are cleared by the kidneys and can, in some cases, cause harm or worsen preexisting kidney

disease,” Coca says. People who are most vulnerable for medication-induced adverse kidney events include those 65 and older, those with underlying kidney disease, people who are dehydrated,

patients with low blood pressure, and those who have comorbid conditions such as diabetes, heart disease or have had heart surgery or transplantation, says Karthik Ramani, a nephrologist at

Michigan Medicine at the University of Michigan. Ramani suggests that prior to taking medications, including over-the-counter and herbal supplements, reach out to a qualified health care

provider or pharmacist and do your own research by getting information from verified sources such as the National Kidney Foundation, the American Medical Association, National Institutes of

Health and the American Society of Nephrology. “In certain situations, such as when you may need to undergo chemotherapy treatment that could be lifesaving but could also cause some damage

to your kidneys, you may decide to proceed with taking the chemotherapy medication even though it can harm your kidneys. You should discuss this type of a situation with your physician and

weigh the benefits against the risks of taking medications,” says Michelle Josephson, M.D., a nephrologist and professor of medicine and surgery at the University of Chicago Department of

Medicine and past president of the American Society of Nephrology. Derek Owen, a clinical pharmacist with the kidney team at the University of Chicago Department of Medicine, warns not to

assume that because a medication can be purchased over the counter, it’s harmless. “Many over-the-counter medications have multiple medications in them, so it’s important to always check the

label to make sure each ingredient is safe for you to take,” he says. Here are some of the medications that can affect your kidneys. 1.   COMMON PAIN MEDICATIONS WHAT THEY ARE: Most

over-the-counter (OTC) pain medications, part of a category of drugs called analgesics, fall into two categories — nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. NSAIDs

relieve pain, reduce fever and treat some cold symptoms. Their ability to reduce inflammation often make them more effective than acetaminophen, which is used to treat mild-to-moderate pain

and to bring down fevers. EXAMPLES: Common OTC nonsteroidals include aspirin (Bayer, Anacin, Bufferin), naproxen (Aleve) and ibuprofen (Advil, Motrin). Prescription NSAIDs are commonly used

to treat pain from arthritis, gout, menstrual cramps and headaches. Acetaminophen includes brands such as Tylenol and Actamin. Some better-known prescription analgesics include codeine,

oxycodone, hydrocodone and methadone. Owen says commonly known NSAIDs may include indomethacin, meloxicam and celecoxib.