Ibuprofen, naproxen and your kidneys

Dr. Joan J. Morales Lappot, MD
3 min read · Leer en español

In briefIbuprofen (Advil, Motrin) and naproxen (Aleve) are in almost every medicine cabinet. For healthy people, occasional use is usually fine. For kidneys that are already strained, they can cause real harm.

How they affect the kidneys

These medicines, called NSAIDs, block substances that keep blood flowing into the kidneys. When the kidneys depend on that extra flow, as in dehydration, heart failure or chronic kidney disease, NSAIDs can cause a sudden drop in kidney function, high potassium, fluid retention and higher blood pressure.

Who should avoid them

• People with chronic kidney disease
• People with heart failure or cirrhosis
• Anyone who is dehydrated, vomiting or has diarrhea
• People taking water pills plus an ACE inhibitor or ARB (a risky combination sometimes called the "triple whammy")
• Older adults taking them every day

Safer choices for pain

• Acetaminophen (Tylenol), within the dose on the label, is usually the first choice
• Topical pain gels or creams for joint pain, which reach the blood in much smaller amounts
• Heat, ice, stretching and physical therapy
• Asking before taking any combination cold or pain product, since many contain an NSAID

If you need one anyway

Sometimes an NSAID is the right tool for a short time. In that case, use the lowest dose for the fewest days, stay well hydrated, and tell your kidney doctor so we can check your blood work.