Drugs and renal impairment

Nephrotoxic drugs

Drugs to avoid/dose-reduce in renal impairment

Always look them up in the BNF if there is any renal impairment:

  • Nephrotoxic drugs (above)
  • Hypoglycaemics
  • Drugs which increase potassium (e.g. supplements, potassium-sparing diuretics, ACE inhibitors)
  • Antibiotics (e.g. ciprofloxacin, nitrofurantoin, some penicillins, trimethoprim, clarithromycin, teicoplanin)
  • Opioids/NSAIDs
  • Statins
  • β-blockers
  • Psychotropics (e.g. lithium, gabapentin, fluoxetine)
  • Anticoagulants (direct oral anticoagulants, low molecular weight heparin)
  • Many others (e.g. allopurinol, colchicine, digoxin, ranitidine)

Try some relevant OSCE prescribing stations

  1. COPD exacerbation prescribing
  2. Pre-operative prescribing
  3. Neutropenic sepsis prescribing
  4. End of life medication prescribing
  5. Asthma exacerbation prescribing
  6. Find more stations here!

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