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September 13, 2019 | 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.

Recommended Allergy Medications

May cause drowsiness :
Diphenhydramine (Benadryl)
Chlorpheniramine (Chlor-Tripolon)

Do not cause drowsiness (but more expensive):
Loratidine (Claritin)
Certirizine (Reactine, Zyrtec)
Fexofenadine (Allegra)

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. 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.

Stool Softener:
Docusate Capsules (Surfak®, Colace®)

Stimulant Laxatives:
Bisacodyl (Dulcolax®), Senna glycosides (Senokot®), Lactulose syrup

Avoid:
Milk of Magnesia®, Magnesium citrate solution, Fleet Phospho-Soda®

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.

Nasal Decongestant Sprays
Otrivin®, Drixoral®, or Novahistine®

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.

Fine to take occasionally Avoid
Amphogel® Maalox®
Gaviscon®  
Tums®  
Riopan®  

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. If you have problems with sleeping contact your physician.

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.

Vitamins to Avoid

Avoid Reason
Other multivitamins Replavite® is a multivitamin specially formulated for people on dialysis. Other multivitamins usually contain Vitamin A and too much Vitamin C.
Vitamin C Can accumulate and cause damage to body organs.
Vitamin A Can accumulate and cause anemia as well as effect cholesterol and calcium levels.
Vitamin D that you buy over the counter Over the counter Vitamin D must be activated in the kidney to work. When you are on dialysis your kidneys cannot do this activation step. You may be prescribed “activated” Vitamin D as calcitriol or alfacalcidol for high parathyroid hormone levels. These forms of Vitamin D will work for people on dialysis.

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