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  • Pain relievers, kidneys

    Which pain relievers don't affect the kidneys?

    I've been trying to sort this out for a long time without much success because it appears all pain relievers can be bad for the kidneys. I'm having kidney issues so I need to find a pain reliever that doesn't harm my kidneys (or my heart -- have had lots of heart problems because of pain meds as well) I'm currently taking gabapentin and the maximum dose of aspirin per day. I can no longer take cox-2 inhibitors, ibuprofen, muscle relaxers, tramadol, and some others I no longer remember the name of and I must limit my intake of acetominophen (kidneys got worse while on vicodin). Any ideas?

    Forgive me if I have asked this question before but I still need a solution to my problem.

    Barb

  • #2
    Barb... if I recall correctly your kidneys were actually in quite fine shape especially for your age as all people's kidney's functioning declines as they get older. Has a doctor actually told you that you must
    be careful of medications you take regarding your kidneys? Based on my memory alone... your kidney functioning was really good even if there was a slight drop between blood test results which can happen just randomly and has no meaning unless it is a consistent and sustained drop combined with the appearance of protein in the urine.

    Pretty much every medicine must be filtered out through the body's liver and/or kidney system. It really can't be avoided, I would discuss your concerns with your doctor and see if there is really a reason to be concerned & if he has any medicine suggestions for you. I certainly can't come up with much...

    Comment


    • #3
      I have been having serious problems with edema. My rheumatologist recommended I see my GP about it and mentioned the possibility I will be referred to a nephrologist. I see my GP tomorrow. I know meds are filtered through the kidneys or liver but some pain meds cause more damage than others so I was hoping for some ideas that I could discuss with both my GP and my rheumatologist.

      Barb

      Comment


      • #4
        Hi Barb.

        I haven't had a lot of experience in needing pain relievers, but I do have lupus nephritis, and both my GP and my nephrologist have nixed ibuprofen and the cox-2 inhibitors for me - in fact most of the NSAIDs are no-gos for me. I have taken tylenol with codeine, as well as Percocet.

        I'm really careful about what I take in terms of over the counter drugs generally because of the potential of kidney harm. I ALWAYS check with the pharmacist before I buy anything OTC - they are very by-the-book so they will always advise you against taking something if kidney disease is one of the contraindications. That said, because they err on the side of caution, here are a couple of things I can actually take that the pharmacist said not to, but I checked with my nephrologist on all of them first.

        The ones on the "no" list really can cause harm. I was put on a standard anti-inflammatory after my hip replacement surgery, and my kidney function declined immediately - I put in a panicked call to my nephrologist, he told the nursing station to stop the drug, and luckily my function returned fairly quickly to what is normal for me. It really reinforced the message for me that these meds are nothing to mess around with....

        Anyways, not sure this is helpful, but I hope your GP appointment goes well, and s/he can suggest something that works for your pain.

        Lisa
        Last edited by oesa; 02-24-2010, 12:08 AM. Reason: added NSAIDs

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        • #5
          I didn't have a very good GP visit. She was clearly having a bad day and wasn't open to discussing much of anything. She reluctantly did blood and urine tests. When I asked her about pain medication that wouldn't be as hard on my stomach, heart and/ or kidneys as aspirin, NSAIDS and the other pain meds that have been ruled out for me, she said gabapentin, Lyrica and Cymbalta only. Said there were no other options. Said she thought my pain and other problems were due to chronic inflammation.

          She didn't discuss the sharp stabbing pain in the lower left rib cage. She prescribed the diuretic, Dyazide, to address the edema.

          When I got home, I researched Dyazide. It is contradicted in people with hypersensitivity to other sulfonamide-derived drugs (sulfa allergy) which I have. It also has the following side effects: subacute cutaneous lupus reactions, photosensitivity, nausea, renal failure, interstitial nephritis, leukopenia, purpura, muscle cramps, dizziness, blurred vision, vasculitis and exacerbation of lupus! WHAT WAS SHE THINKING?! I already have many of these symptoms, conditions.

          I no longer feel I can trust her with my health. And she's the one who discovered I was ANA positive in 2008 and was the first one to suspect I have lupus. I just don't get it. Is she trying to create a medical emergency to prove something?

          Barb

          Comment


          • #6
            Barbs,

            Sorry things didn't go how you wanted!

            Important to remember that all medications come with a leaflet of minor to major side effects and why the drug should not be taken...does not mean you shoudn't and should sistrust your GP/doctor/specialist.

            I use Imigran for migraines it contains Sulphur, I'm allergic to Septrin a Sulphur based antibiotic (like Bactrim), but it seems okay and have been using it for 12 months now.

            I have many side effects to medications many of them the RARE ones, but that never stops me trying a new medication that may work and be a wonder drug for me. I can honestly say that I would never really consider not to take a medication just based on the medication leaflet and I do get those anaphlatic, and/or rare reactions. Trial and error can hopefully lead to a better quality of life and that life in my opinion will only happen the once...live it and be medicated, pain free and in control!

            The choice is yours Barbs, by all means call your GP and double check that they are sure this new medication is okay in their opinion, but don't disrespect their opinion before you ask them to clarify.

            Who knows, this medication may be the one for you!


            As to the ANA postive...it's only a auto-immune indicator and can be positve in those without something going on. I have SLE...and only ever positive as high as 1:320, it never gets tested now as its not an idicator at all of disease severity! ANA postive at the start of investigations are important...then onto all the other tests and physical problems.

            Good luck with everything...keep an open mind!

            Comment


            • #7
              I have been allergic to sulfa drugs for at least 20 years. I have had serious allergic reactions to sulfa drugs on at least three occasions and it was documented in bold with warnings in my medical records by my physicians at that time (I have copies) i.e. I am not to take sulfa drugs ever, under any circumstances, just like my son who is allergic to penicillin isn't to be given penicillin under any circumstances because it could kill him.

              Comment


              • #8
                Hi Barb,

                Pardon my ignorance but when you say sulfa, is that similar to sulphaselazine (sorry if misspelt) ? My reason for asking is because my doctor didn't want to prescribe me that as she said it would make the lupus worse. Another person I have been in contact with said she was on that medication for years and has recently been diagnosed with SLE and they believe it was drug induced lupus.

                Im allergic to penicillin too and I dislike it when doctors ask me got would happen if I were given penicillin but to be honest I don't know. I just know I was given too much penicillin as a child and must have had a reaction because my mother was told that I could no longer have it and had become allergic to it.

                I understand your frustration in finding a medication that help without causing any further damage. I have just been prescribed methotrexate because I also have RA and know that this medication is also used for lupus patients. Like you I am terrified in taking it because of major side affects. I feel I am between two evils, do I let the illness progress or do I take something that could give me another illness like cancer as it's quite toxic. I know I will have regular blood tests to monitor my liver and kidneys but my worry is what happens if by then is too late - it's a tough one hun.

                I also agree with what has been said in that all medications have side affects. I take pain killers every day and worried that those will eventually have an affect but I either live in aggressive pain or try to ease them.

                I totally understand where you are coming from.

                Lots of hugs from me x

                Eve

                Comment


                • #9
                  Hi Vina-Del-Mar,

                  I am allergic to sulfonamides and all sulfonamide-containing drugs. Septra is one sulfonamide-containing drug that I have had a serious allergic reaction to at least once, maybe twice. Hypersensitivity to sulfonamide-containing drugs can be life threatening.

                  My son nearly died when he was two months old. He developed bacterial pneumonia. They prescribed a penicillin-based antibiotic. He turned bright red all over and screamed nonstop for days. He had to be hospitalized, sedated and placed in an oxygen tent. It was touch and go for a long while. He is not to receive penicillin ever again because it will likely kill him.

                  My GP knows about my allergy, that's why I'm so alarmed by the prescription she wrote. What if I didn't research it, just had it filled and took it as prescribed, without question?!! I live alone. Something could have happened and no one would know for days.

                  Barb

                  Comment


                  • #10
                    Hi Barb,

                    Sorry to hear about what happened with your son when he was a baby and do empathise with you as a mother, must have been a very traumatic experience and Im so glad he pulled through. Bless him. I too had bronchial pneumonia at 3 months old and given penicillin, my mother constantly worries about me and always gets me to ask if something has penicillin. Does your son carry a card or something written down that he is allergic to penicillin? I write it down on a diary.

                    Thank you for the explanation and so pleased to researched it. Im disgusted that your GP didn't even bother looking at his notes. I have had similar experiences and a couple of years ago my GP wanted to prescribe HRT even though I was only 42 at the time and not menopausal but he didn't want to refer me to a gynecologist as he think he knows more than specialists. Like you I researched it and lupus patient shouldn't have it and even more so if they are cardiolipin positive, which I am. I immediately spoke to my rheumatologist who was surprised and annoyed so she wrote to him. However, he was still adamant that he was in the right and she was wrong. My rheumatologist had to refer me to gynecologist when he should have done considering here in the UK it is GP's that have control of referrals.

                    You shouldn't have to keep an eye on everything that is prescribed to you hun but so very glad that you have. Shame on your GP and think he should be pulled up for it.

                    Please keep in touch and hope they prescribe the correct medication.

                    Eve

                    Comment


                    • #11
                      My son is supposed to wear a medical alert bracelet or tag but he refuses. He thinks that either he or someone else will be able to tell medical care providers about his allergy when/if the need arises. He doesn't understand how serious the problem is and refuses to educate himself. In other words, he's in denial.

                      Comment


                      • #12
                        Got the results of my labs back. My kidneys are fine. My heart appears fine as well. I don't consume much salt (don't eat out, don't eat frozen foods, don't eat canned foods, rarely eat chips or salted nuts, don't cook with much salt, can't stand to eat much salt in general, ever) In fact, my General Chemistry (metabolic?) panel is the picture of good health and my TSH is normal so what could be causing serious bouts of edema almost daily? Could inflammation alone cause serious bouts of edema in hands and from the waist down?

                        Barb

                        Comment


                        • #13
                          Hi Barb,

                          Im so pleased your blood results came back fine. I know that doesn't solve the problem of edema and you could have a point there hun, maybe inflammation can do that. Have you asked your rheumy?

                          Eve

                          Comment


                          • #14
                            Maybe it is something that you will just have live with?

                            I have relatives that their ankles swell up and they are ok. Cardiologists know about it and are not concerned.

                            Take care,
                            Lyn

                            Comment


                            • #15
                              Eve, I did ask my rheumatologist. He's the one who sent me to my GP about it. Still no answers (or guidance) from anyone.

                              Got more blood test results back --- CBC with differential --- but no one has provided me with the results of my urinalysis even though I have requested it twice. The CBC with differential reveals lymphopenia. I'm guessing the urinalysis showed protein leakage like it did a year ago and I'll have to wait until my next appointment with the rheumatologist to get the results (I have been testing my urine at home using the same dip sticks used by physicians. My results show a trace to 100++ level of protein leakage off and on). The rheumatologist mentioned the possibility I'll need to see a nephrologist the last time I saw him. I'm guessing the situation is borderline and is being monitored right now but I don't understand why they refuse to inform me of the results. My next appointment with the rheumatologist isn't until June.

                              My GP thinks the edema as well as the pain is caused by inflammation due to lupus and is frustrated by my rheumatologist's lack of action but I carry a virus in my body and have other health problems that make prescribing prednisone or methotrexate or other immunosuppressants kind of dicey so I haven't pushed the rheumatologist for that stuff yet. I know prednisone would help immensely. That's probably what I should be on. I should be getting a second opinion from a specialist at the university or the Mayo Clinic but can't afford to do that. And why do I have to keep pushing for help? Why don't they just give it?

                              I faxed a letter to my GP about being unable to take Dyazide due to sulfa allergy. I haven't received a response from her about it despite leaving a phone message and sending a second fax requesting she get back to me about it. I can't even get verification she received the fax. So Lyn, yes I guess I have to continue to live with the edema (and pain) like I have for the past 15 years and continue with massive doses of aspirin to try to manage the pain and inflammation. It's all so demoralizing.

                              Barb

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