Dialysis and Over The Counter Medications

Allergy Medications (also called Antihistamines)

It is safe to take most over the counter allergy medications in the normal doses as they are eliminated from your body through the liver. If you have liver problems check with your pharmacist or physician first before using.

 

Constipation

Constipation is a common problem for people receiving dialysis as both iron tablets and calcium tablets can cause this side effect. In addition, you may be on other medications, which can cause constipation (for example, Tylenol #3®, Percocet®).

 

If you are taking a medicine on a daily basis which can cause constipation you should also take a stool softener once or twice daily to prevent constipation. You do not need to take this with lots of additional fluid which is often recommended. If you are already constipated you can take a stimulant laxative. After the constipation is relieved go back to taking your stool softener daily. Do not use the stimulant laxative on a daily basis as your bowels will become used to the laxative and will not move on their own.

 

Cough & Cold Medicine

It is safe to take most cough and cold medications, except if you have diabetes or high blood pressure.

Diabetes

Many cough syrups and lozenges contain sugar. If your diabetes is well controlled, using these medications short-term for a cold is usually not a problem. If your diabetes is not well controlled or you would like to avoid the extra sugar there are sugar-free formulations. Ask your pharmacist to help you choose a product.

 

High Blood Pressure

Avoid using syrups, tablets, or capsules that have the words “Nasal Decongestant” on the package. Nasal decongestants work by constricting the veins in your nose to relieve the swollen, congested feeling. If you take a nasal decongestant in the form of a syrup, tablet, or capsule you will cause constriction of not only the veins in your nose but also the veins found elsewhere in your body. This can increase your blood pressure. If you have a stuffy nose use a nasal decongestant spray as very little of the spray will be absorbed outside of your nasal passage.

Diarrhea

You can take Loperamide (Imodium®) tablets for diarrhea in the usual dose. Do not take more than 8 tablets per day.

Heartburn

Most over the counter medications for heartburn are fine to use occasionally. If you find that you are using heartburn medication every day you should contact your physician. There may be a more serious problem such as an ulcer, and many of the medications used to treat heartburn have ingredients which, if used often, can accumulate in people with kidney disease.

 

Herbal Products

Herbal products may interact with the other medications you are taking. You should check with the dialysis pharmacist or physician before using.

Pain Medications

Acetaminophen (Tylenol®) is safe to use. If you have liver problems you should check with your pharmacist or physician first. Do not take more than 12 regular strength tablets or 8 extra strength tablets per day. Acetaminophen will relieve pain and fever but NOT inflammation.

 

Ibuprofen or aspirin will relieve pain, fever, AND inflammation and are fine to use occasionally. If you have a history of ulcers or a stomach bleed you should try to avoid these medications.

Sleep

Most over the counter sleep medicines are just allergy medications which cause drowsiness. They are not often very effective. Melatonin 3mg daily at bedtime has been shown to be effective and safe in hemodialysis patients in a short term study.

If you have problems with sleeping contact your physician or nurse practitioner though.

Vitamins

Your Replavite® tablet is a good multivitamin for people on dialysis as it provides the vitamins which dialysis can remove. It contains B Vitamins, Folic Acid, and a small amount of Vitamin C.

 

Modified from the Manitoba Renal Program:

Séadna Ledger BSc.Phm (May 2013)