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__NOTOC__
__NOTOC__
{{SI}}
{{SI}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}, {{AN}}


==Overview==
==Overview==
Nephrotoxic drugs are pharmacotherapies that can lead to a decline in renal function.  The drug may need to be discontinued, or the dosing reduced when this happens.
Nephrotoxic drugs are pharmacotherapies that can lead to a decline in renal function.  The drug may need to be discontinued, or the dosing reduced when this happens.
==Common Nephrotoxic drugs==
*[[Acetaminophen]]
*[[Aspirin]]
*[[H1 antagonist]]
*[[Cephalosporins]]
*[[Cocaine]]
*[[Diuretics]]
*[[NSAID]]s
*[[Penicillin]]s
*[[Proton pump inhibitors]]
*[[Angiotensin converting enzyme inhibitor]]s
*[[Statins]]


==Antibiotics==
==Antibiotics==
===Antibacterials===
*[[Aminoglycosides]] (10-15% Incidence of [[acute tubular necrosis]])
:*Occurs in 10-20% patients on 7 day course
:*Results in non-oligurics; increased [[creatinine]]
:*A single dose early in septic course is usually safe
*[[Amphotericin B]] (Incidence 80-90%)
*[[Ciprofloxacin]]
*[[Chloroquine]]
*[[Erythromycin]]
*[[Gentamycin]]
*[[Hydroxychloroquine]]
*[[Isoniazide]]
*[[Levofloxacin]]
*[[Methicillin]]
*[[Rifampin]]
*[[Sulfonamides]]
*[[Tetracycline]]
*[[Trimethadione]]
*[[Vancomycin]]
===Antivirals===
*[[Acyclovir]] (only nephrotoxic in intravenous form)
*[[Acyclovir]] (only nephrotoxic in intravenous form)
*[[Aminoglycosides]] (10-15% Incidence of Acute Tubular Necrosis)
*[[Adefovir]]
:* Occurs in 10-20% patients on 7 day course
*[[Cidofovir]]
:* Results in non-oligurics; increased [[Creatinine]]
*[[Foscarnet]]
:* A single dose early in septic course is usually safe
*[[Indinavir]]
* [[Amphotericin B]] (Incidence 80-90%)
*[[Tenofovir]]
* [[Ciprofloxacin]]
===Antiparasitic drugs===
* [[Levofloxacin]]
*[[Chloroquine]]
* [[Pentamidine]]
*[[Hydroxychloroquine]]
* [[Rifampin]]
*[[Pentamidine]]
* [[Sulfonamides]]
*[[Quinine]]
* [[Tetracycline]]
 
==Chemotherapy and Immunosuppressants==
==Chemotherapy and Immunosuppressants==
* [[Cisplatin]]
*[[Cisplatin]]
* [[Cyclosporine]]
*[[Cyclosporine]]
* [[Methotrexate]]
*[[Interferon alpha]]
* [[Mitomycin]]
*[[Methotrexate]]
*[[Mitomycin]]
*[[Foscarnet]]
*[[Tacrolimus]]


== Heavy Metals==
== Heavy Metals and Poisons==
* [[Arsenic]] Poisoning
*[[Arsenic]] poisoning
* [[Bismuth]]
*[[Bismuth]]
* [[Mercury]] Poisoning
*Gold therapy
* [[Lead]] Poisoning
*[[Lead]] poisoning
* [[Lithium]] related kidney disorders
*[[Lithium]] related kidney disorders
:* [[Polydipsia]] and [[Nephrogenic Diabetes Insipidus]]
:*[[Polydipsia]] and [[nephrogenic diabetes insipidus]]
:* [[Acute Renal Failure]]
:*[[Acute renal failure]]
:*:* [[Dialysis]] indications: [[Creatinine]] >2.5 or [[Seizure]]s, ALOC, [[Rhabdomyolysis]]
:*:*[[Dialysis]] indications: [[serum creatinine]] >2.5 or [[seizure]]s, [[rhabdomyolysis]]
:* [[Chronic kidney disease]] with [[fibrosis]]
:*[[Chronic kidney disease]] with [[fibrosis]]
*[[Mercury]] poisoning
*[[Nitrosourea compounds]]


==AntiHyperlipidemics==
==AntiHyperlipidemics==
* [[Fenofibrate]] (Tricor)
*[[Fenofibrate]] (Tricor)
:* Increases Serum [[Creatinine]] without significant decrease in [[GFR]]
:*Increases [[serum creatinine]] without significant decrease in [[GFR]]
:* Serum [[Creatinine]] rise is reversible on stopping [[Fenofibrate]]
:*[[Serum creatinine]] rise is reversible on stopping [[fenofibrate]]
* [[Gemfibrozil]]
*[[Gemfibrozil]]
:* Associated with [[Acute Renal Failure]] due to [[Rhabdomyolysis]]  
:*Associated with [[acute renal failure]] due to [[rhabdomyolysis]]  
* [[Statin]]s  
*[[Statin]]s  


==Chemotherapy==
==Chemotherapy==
* [[Cisplatin]]
*[[Carmustine]]
* [[Ifosfamide]]
*[[Carboplatin]]
:* Causes [[Fanconi's Syndrome]]
*[[Cisplatin]]
*[[Ifosfamide]]
:* Causes [[fanconi's syndrome]]
*[[Lomustine]]
 
==Proton channel blockers==
*[[Esomeprazole]]
*[[Lansoprazole]]
*[[Omeprazole]]
*[[Pantoprazole]]
*[[Rabeprazole]]


==Miscellaneous Drugs==
==Miscellaneous Drugs==
* Chronic stimulant [[laxative]] use
:* Resulting chronic volume depletion and [[hypokalemia]] causes [[nephropathy]]
* [[Radiocontrast agents]]
* [[ACE Inhibitor]]s
:* Expect an increase of [[serum creatinine]] in [[chronic kidney disease]]
*[[Acetaminophen]]
*[[Amitriptyline]]
*[[Anticoagulants]]
*[[Allopurinol]]
*[[Aspirin]]
:* Low dose [[aspirin]] reduces [[renal function]] in elderly
:*:* Decreased [[creatinine clearance]] after 2 weeks of use
:*:* Changes persisted for at least 3 weeks off [[aspirin]]
*Aristocholic acid containing Chinese herbals
*[[Bevacizumab]]
*[[Carbon tetrachloride]]
*[[Cimetidine]]
*[[Ciprofloxacin]]
*[[Clopidogrel]]
*[[Dilantin]]
*[[Diuretic]]s
:*[[Thiazide]]s
:*[[Furosemide]]
:*[[Triamterene]]
*[[Doxepin]]
*[[Fluoxetine]]
*[[H1 antagonist]]s
:*[[Diphenhydramine]]
:*[[Doxylamine]]
*[[Infliximab]]
*[[Interferon]]s
*[[Mesalamine]] (Asacol, Pentasa)
:*[[Mesalamine]] is an [[NSAID]] analog and has systemic absorption from the bowel
*[[NSAID]]s: [[celecoxib]], [[ibuprofen]], [[naproxen]]
:*[[Nephrotic syndrome]] type reaction
*[[Penicillin]]s and [[cephalosporin]]s
*[[Pamidronate]]
*[[Propylthiouracil]]
:*[[Hypersensitivity]] ([[fever]], [[rash]], [[arthralgia]])
*[[Rifampin]]
*[[Sulfonamide]]s
:*[[Vasculitis]] reaction
*[[Ticlopidine]]
*[[Zoledronate]]


* Chronic Stimulant [[Laxative]] use
==Drugs of abuse==
:* Resulting chronic volume depletion and [[Hypokalemia]] causes [[nephropathy]]
*[[Cocaine]]
* Radiographic contrast
*[[Heroin]]
*[[Ketamine]]
*[[Methadone]]
*[[Methamphetamine]]
 
==Nephrotoxic Drugs in Alphabetical Order==
{{MultiCol}}
* [[ACE Inhibitor]]s
* [[ACE Inhibitor]]s
:* Expect an increase of Serum [[Creatinine]] in [[Chronic kidney disease]]
* [[Acetaminophen]]
* [[NSAID]]s
* [[Acyclovir]]
* [[Adefovir]]
* [[Allopurinol]]
* [[Aminoglycosides]]
* [[Amitriptyline]]
* [[Amphotericin B]]
* [[Angiotensin converting enzyme inhibitor]]s
* [[Anticoagulants]]
* [[Aristocholic acid containing Chinese herbals]]
* [[Arsenic]] poisoning
* [[Aspirin]]
* [[Aspirin]]
:* Low dose [[Aspirin]] reduces [[Renal function]] in elderly
* [[Bevacizumab]]
:*:* Decreased [[Creatinine Clearance]] after 2 weeks of use
* [[Bismuth]]
:*:* Changes persisted for at least 3 weeks off [[Aspirin]]
* [[Carbon tetrachloride]]
* [[Carboplatin]]
* [[Carmustine]]
* [[Celecoxib]]
* [[Cephalosporins]]
* [[Chloroquine]]
* [[Cidofovir]]
* [[Cimetidine]]
* [[Ciprofloxacin]]
* [[Cisplatin]]
* [[Clopidogrel]]
* [[Cocaine]]
* [[Cyclosporine]]
* [[Dilantin]]
* [[Diphenhydramine]]
* [[Diuretics]]
* [[Doxepin]]
* [[Doxylamine]]
* [[Erythromycin]]
* [[Esomeprazole]]
* [[Fenofibrate]] (Tricor)
* [[Fluoxetine]]
* [[Foscarnet]]
* [[Furosemide]]
* [[Gemfibrozil]]
* [[Gentamycin]]
* [[Gold]] therapy
* [[H1 antagonist]]
* [[Heroin]]
* [[Hydroxychloroquine]]
{{ColBreak}}
* [[Ibuprofen]]
* [[Ifosfamide]]
* [[Indinavir]]
* [[Infliximab]]
* [[Interferon alpha]]
* [[Interferon]]s
* [[Isoniazide]]
* [[Ketamine]]
* [[Lansoprazole]]
* [[Laxative]] use
* [[Lead]] poisoning
* [[Levofloxacin]]
* [[Lithium]]
* [[Lomustine]]
* [[Mercury]] poisoning
* [[Mesalamine]] (Asacol, Pentasa)
* [[Mesalamine]] (Asacol, Pentasa)
:*:* [[Mesalamine]] is an [[NSAID]] analog and has systemic absorption from the bowel
* [[Methadone]]
* [[Penicillin]]s and [[Cephalosporin]]s
* [[Methamphetamine]]
:* [[Hypersensitivity]] ([[fever]], [[rash]], [[arthralgia]])
* [[Methicillin]]
* [[Sulfonamide]]s
* [[Methotrexate]]
:* [[Vasculitis]] reaction
* [[Mitomycin]]
* [[Naproxen]]
* [[Nitrosourea compounds]]
* [[NSAID]]s
* [[NSAID]]s
:* [[Nephrotic Syndrome]] type reaction
* [[Omeprazole]]
* [[Pamidronate]]
* [[Pantoprazole]]
* [[Penicillin]]s
* [[Pentamidine]]
* [[Propylthiouracil]]
* [[Proton pump inhibitors]]
* [[Quinine]]
* [[Rabeprazole]]
* [[Radiocontrast agents]]
* [[Rifampin]]
* [[Rifampin]]
* [[Diuretic]]s ([[Thiazide]]s and [[furosemide]])
* [[Statins]]
* [[Allopurinol]]
* [[Sulfonamides]]
* [[Cimetidine]]
* [[Tacrolimus]]
* [[Ciprofloxacin]]
* [[Tenofovir]]
* [[Dilantin]]
* [[Tetracycline]]
* [[Thiazide]]s
* [[Ticlopidine]]
* [[Triamterene]]
* [[Trimethadione]]
* [[Vancomycin]]
* [[Zoledronate]]
{{EndMultiCol}}


==Drugs of abuse==
==References==
* [[Cocaine]]
{{reflist|2}}


[[Category:Drugs]]
[[Category:Drugs]]

Latest revision as of 16:16, 10 August 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Aarti Narayan, M.B.B.S [3]

Overview

Nephrotoxic drugs are pharmacotherapies that can lead to a decline in renal function. The drug may need to be discontinued, or the dosing reduced when this happens.

Common Nephrotoxic drugs

Antibiotics

Antibacterials

  • Occurs in 10-20% patients on 7 day course
  • Results in non-oligurics; increased creatinine
  • A single dose early in septic course is usually safe

Antivirals

Antiparasitic drugs

Chemotherapy and Immunosuppressants

Heavy Metals and Poisons

AntiHyperlipidemics

Chemotherapy

Proton channel blockers

Miscellaneous Drugs

Drugs of abuse

Nephrotoxic Drugs in Alphabetical Order


References


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