If I Need Pain Medicines What Can I Do To Keep My Kidneys Healthy
Kidney disease caused by pain relievers is often preventable. Here are some things you can do to help keep your kidneys healthy.
How you take these medicines makes a difference:
- Make sure you read the warning label before using any overthecounter analgesics.
- Do not use overthecounter pain relievers more than 10 days for pain or more than three days for fever. If you have pain or fever for a longer time, you should see your doctor.
- Avoid using pain medicines that contain a combination of ingredients, like aspirin, acetaminophen and caffeine mixed together in one pill.
- If you are taking pain medicines, increase the amount of fluid you drink to six to eight glasses a day.
- If you are taking pain medicines, avoid drinking alcohol.
Talking with your doctor about pain medicines can also make a difference:
- If you have kidney disease, ask your doctor before taking a pain medicine, particularly NSAIDs and higher dose aspirin.
- If you have high blood pressure or heart disease, make sure you only take NSAIDs under your doctors supervision. This is especially important if you take diuretic medications or are over 65 years of age.
- Make sure your doctor knows about all medicines you are taking, even over-the-counter medicines.
Fast Safe And Effective Rapid Detox Treatment
Rapid detox is a method of treatment to end physical opioid dependence. In this treatment conducted in a hospital, you, the patient, receive sedation for a relatively short period while a medical doctor flushes the opioids from your system, pushing them off the opioid receptors. When you wake up, you are no longer physically dependent, youve already experienced the worst of the acute withdrawal, and you can move on to a short recovery period and adjusting to an opioid-free life.
Similarly, non-anesthesia medical detox involves detoxification in a hospital under the supervision of a medical doctor. Both treatments ensure the safety and effectiveness of the detox process by providing medical care throughout treatment.
A leader in rapid detox treatment is Waismann Method®, which has been successfully performing detox treatments on thousands of patients for over 21 years. Waismann Method® enhanced its approach to rapid detox and non-anesthesia medical detox by using superior medical protocols tailored to each patients unique medical and emotional needs. The process begins with a comprehensive medical evaluation, including assessing organ function, so that the medical team can appropriately monitor all vitals throughout treatment. This approach, combined with the treatment centers safety standards and an unmatched level of experience, dramatically increases the patients likelihood of completing detox to become opioid-free.
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Is Vicodin Safe For Chronic Kidney Disease Patients
Because of back pain, headache, painful legs or feet, abdominal pain, and so on, Chronic Kidney Disease patients need to take pain killers to relieve them. Vicodin is one common pain killer, because it contains both acetaminophen and hydrocodone. However, quite a part of pain killers have renal toxicity, so kidney patients are required to avoid these medications. Then, is vicodin safe for kidney patients?
So far, no research has definitely proven vicodin has renal toxicity, but the pharmacist does suggest patients to tell their doctor in advance if they have kidney or liver disease. That is to say, vicodin may have some potential side effects for these patients.
The common side effects of vicodin for CKD patients
Vicodin is often used to relieve moderate or severe pain. As one common painkiller, its most frequent side effects include dizziness, nausea, vomiting, browsiness, feeling weak, low blood pressure, and so on.
In severe cases, some infrequent adverse reactions may also happen. They are constipation, change in pulse, feeling confused, fast heartbeat, trouble breath, significant decrease in lung function, difficulty in urinating, etc. If kidney patients suffer from difficult urination, their illness condition may be aggravated quickly as extra fluid and waste products build up in the body.
Can Chronic Kidney Disease patients take vicodin safely?
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Ckd Due To Amyloidosis From Skin Popping With Opioids
In the 1980s, skin popping a form of intradermal injection, usually after consuming normal venous access by illicit drug users were noted to be connected to amyloidosis. Patients presented with chronic suppurative skin infections, nephrotic syndrome with peripheral edema, a bland urinary sediment and normal to large kidney on renal imaging along with renal tubular acidosis and diabetes insipidus. Rapid progression to advanced CKD was noted .
Regular Use Of Pain Medicines Doesn’t Damage Kidneys
July 17, 2001 — Aspirin and similar pain medicines are such a part of everyday life — about a quarter of U.S. adults use them weekly — that most of us assume they’re perfectly safe. But for years, doctors have cautioned that regular use of these drugs can cause major damage to your kidneys and cause bleeding in the stomach.
A new study gives us one less thing to worry about: Moderate use of over-the-counter pain relievers isn’t likely to lead to kidney problems, the researchers found. However, two doctors who reviewed the study for WebMD believe overuse of pain medicines, particularly over a long period of time, may still be harmful.
The study in July 18 issue of the Journal of the American Medical Association looked at the use of nonprescription pain medicines such as aspirin, acetaminophen and non-steroidal anti-inflammatory drugs such as Motrin, Advil, or Aleve in more than 11,000 healthy men over a 14-year period.
They found no increase in kidney problems among men who took an average of three or four pills a week The study didn’t look at other possible side effects of these drugs such as harm to the liver or gastrointestinal bleeding.
People in the U.S. tend to drink too little water, and that puts additional stress on the kidneys, Avram says. “When you look at elderly people who drink only a small amount of water, and also take lots of pain medicines, that’s a set-up for disaster.”
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How Opioid Use Can Harm Your Kidneys
Both prescription opioids and illicit opiate drugs can, directly and indirectly, cause internal damage, including to the kidneys. Additives in street heroin, for example, can include substances that do not readily dissolve, clogging the blood vessels leading to organs such as the kidneys and causing infection or death of small patches of organ cells, according to the National Institute on Drug Abuse.
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Key Points About Analgesic Nephropathy
- Long term use of pain killers can cause damage to the kidneys. This includes over-the-counter and prescription pills.
- This condition is most common in people older than 45 years of age, and more prevalent in women over 30.
- Often there are no symptoms. It may be found on routine blood or urine tests.
- Symptoms are related to the build-up of toxins and waste products that are normally filtered by the kidneys.
- Analgesic nephropathy can lead to acute kidney failure, cancer, or atherosclerosis in later stages.
Heroin And The Kidneys
When this happens, there is the potential for damage to the kidneys.
Essentially what happens with rhabdomyolysis is a breakdown of tissue during an overdose-related coma because the person has been not moving for an extended period. The muscles start to disintegrate and that produces chemicals, which then go into the bloodstream and set off other damaging reactions throughout the organs. This is one of the number one reasons for kidney failure. During this situation, heart damage and heart attack can also occur.
Also, people who use heroin intravenously may be more likely to contract infections that can lead to kidney inflammation, and for people who inject heroin under the skin, theres an increased chance of getting secondary amyloidosis. This is a buildup of protein in organs and tissues that can lead to kidney failure.
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Pharmacological Update On Opioid Analgesics In Ckd
Exogenous opioids work as analgesics, by mimicking and potentiating a physiological endogenous modulating system, mediated by endorphins, and their activity on opioid receptors. Four seven-transmembrane G protein-coupled opioid receptors have been identified: µ , , k and nociceptin opioid receptor . The four major families of endogenous ligands are: -endorphins, enkephalins, dynorphins, and nociceptin/orphaninFQ. Opioids inhibit neurotransmission by their activity on calcium and potassium channels. Opioid receptors on the primary afferent fibers prevent calcium influx in the first-order neuron and further release of excitatory neurotransmitters, such as glutamate and substance P. On the other side of the synaptic cleft, in the dorsal horn, opioid receptors are also expressed by second-order neurons, where they activate G protein gated inwardly rectifying potassium channels and induce post-synaptically hyperpolarization.32 The net result of these processes is an effective modulation of pain transmission and clinical relevant analgesia .
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Table 1 Pharmacology of Opioids for Chronic Pain Management39,40 |
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Table 2 Clinical Use of Opioids for Chronic Pain Management in CKD and HD Patients28,30,39 |
Patients with a severe impairment of glomerular filtration can be treated with fentanyl, sufentanil, buprenorphine, and tapentadol, which appear to have a safer renal profile.28,49,64
Use Of Opioids In Ckd
Metabolism of opioids with CKD is altered. For example, in 620 cancer patients, serum fentanyl concentrations and metabolic ratios were found to vary considerably between patients on transdermal fentanyl patches based on various factors including cytochrome genotypes and clinical factors like gender, other medications, presence of kidney disease, serum albumin and obesity .
In CKD, morphine has an increase in the mean peak concentration and the area under the concentration-time curve for both active and principle metabolites. With CKD, the metabolites of merperidine are present for longer and can decrease the seizure threshold and should be avoided for chronic use. Extended effects of codeine and dihydorcodeine with CKD have been reported. Pharmacokinetics of buprenorphine, alfentanil, sufentanil and remifentanil are not significantly altered in patients with renal failure .
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Cases Of Liver Injury
There are many case histories of liver damage from the use of amphetamines, particularly MDMA. A German teen who had been abusing MDMA on weekends for a few months suddenly developed jaundice and fatigue. His tests showed the presence of liver injury resulting from his drug abuse. Over the next four months, his test results recovered to a normal level.
A 32-year-old woman who had just used MDMA suffered a collapse associated with liver injury. She wound up in intensive care on a ventilator and was finally released ten days later.
In 1996, a study was made of seven young men who died after abusing MDMA or a similar drug. All had severe changes in their livers, and in one case, the liver was destroyed by the effects of the drug.
Stimulants are very destructive to the brain and the nervous system. When the brain is affected, ones entire physical or emotional balance can be lost. More information is available on the next page.
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What Are The Side Effects Of Hydrocodone
People who take opioids may experience dry mouth and overall itchiness. Its possible that the drug will cause swelling in the hands or feet. Muscle pain and back pain are possible. Hydrocodone may cause cold-like symptoms, such as sneezing, sore throat, or stuffy nose. Drowsiness or overall fatigue is possible, and sometimes the drowsiness is severe. Users may have difficulty sleeping.
Some side effects are less common. For instance, some people who take hydrocodone experience pain or burning when they urinate. Tremors, confusion, or severe drowsiness is possible. Sexual problems, including impotence and a loss of interest in sex, are possible. Women may experience infertility or miss a period. In some instances, hydrocodone may lower cortisol levels and lead to nausea, a loss of appetite, dizziness, and vomiting.
Hydrocodone has the potential to cause shallow or weak breathing, and it is not to be taken be taken by people who have asthma or another respiratory condition. The breathing issues may be serious or life-threatening. Respiratory distress may be greater at higher dosages and may cause death on the first use if given at too high a dose, as indicated by Purdue Pharma. Respiratory distress may be treated at the hospital with oxygen, intubation, or a ventilator.
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Context Of Renal Failure From Opioid Use
It is important to note that opioids are commonly used safely in anesthesia and pain control in the perioperative period in those with kidney disease. The renal toxicity appears in the context of inappropriate use: either inadvertently higher than needed doses, in the presence of other toxins, with pre-existing dehydration, or prostate enlargement. Chronic use of opioids, as noted by Novick et al. , results in greater incidence of toxicity due to accumulation of metabolites, which could cause unwanted side effects. One reason is that with chronic use, a steady state of the drug is reached with distribution and accumulation in the various body compartments. With a pro-drug that is metabolized to morphine, both the drug and the intermediary metabolite levels may also build up in the various compartments, resulting in unwanted side effects.
In the context of CKD, an increasingly important finding in nephro-pharmacology has been the unexpected alterations in the non-renal metabolism of drugs that had led to changes in Food & Drug Administrations guidance to industry .
Pain Medicines: What To Do If You Have Heart Problems Or Kidney Disease
When people have pain, they often take pain medicines called NSAIDs . These include:
- Advil and Motrin . Ibuprofen is also in other over-the-counter drugs, such as cold medicines.
- Aleve .
- Celebrex .
NSAIDs help ease pain and inflammation. But if you have high blood pressure, heart failure, or kidney disease, you should not take an NSAID. And you should not take any drugs that have ibuprofen or another NSAID in them. Heres why:
NSAIDs are bad for your blood pressure.
NSAIDs can cause high blood pressure. And if you have high blood pressure, they can make it worse. This increases your chances of having a heart attack or a stroke.
NSAIDs can also keep some blood pressure drugs from working right. NSAIDs can interfere with:
- Diuretics, or water pills, such as apo-Hydro .
- Diuretics remove excess water from the blood vessels.
- ACE inhibitors, such as Altace and Coversyl .
- ACE inhibitors are drugs that relax the blood vessels.
- ARBs such as Cozaar . ARBs are another group of drugs that relax the blood vessels.
NSAIDs are bad for your heart and kidneys.
Long-term use of NSAIDs can make your body hold onto fluid. This can worsen the symptoms of heart failure, such as shortness of breath, swollen ankles, and a rapid or irregular heartbeat. NSAIDs can also keep the kidneys from working well. This makes taking NSAIDs risky for people who already have kidney disease.
Which painkillers can you use if you have heart or kidney disease?
Managing pain without taking drugs
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How Norco And Alcohol Affect The Liver
According to RxList, individuals should disclose any personal or family history regarding alcohol or substance abuse to their doctor before taking Norco. Assessing an individuals drinking behavior is important in deciding whether to take the drug for legitimate medical reasons. It is even recommended that an individual abstain from consumption of alcohol for about a week after taking any drug with acetaminophen in it.
Dangers of Mixing Alcohol and Drugs
Drugs That Inhibit Activity Of Certain Enzymes In The Liver
Taking this medication with drugs that can inhibit activity of certain liver enzymes can increase the amount of hydrocodone in your body and cause more side effects. You may have increased breathing problems or drowsiness. Examples of these drugs include:
- erythromycin
- protease inhibitors used to treat HIV, such as ritonavir
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Rhabdomyolysis And Aki With Opioids
In the setting of non-medical opioid use with dehydration, immobility, and with decreased respiratory drive, there is a drop in MAP, renal blood flow, GFR, and hypoxia. In addition, frequently there may be other toxins involved as with polysubstance abuse.
Myocyte hypoxia and immobility result in muscle damage, starting with hypoxia and resultant ATP depletion leading to an increase in unregulated intracellular calcium and a cascade of destruction with further muscle damage, which results in lysosomal digestion of muscle. The muscle breakdown products and other intra-cellular components are released into the serum and these include myoglobin, phosphate, potassium and other markers like creatinine phosphokinase .
What Should I Discuss With My Healthcare Provider Before Taking Acetaminophen And Hydrocodone
You should not use this medicine if you are allergic to acetaminophen or hydrocodone, or if you have:
- severe asthma or breathing problems; or
- a blockage in your stomach or intestines.
Tell your doctor if you have ever had:
- breathing problems, sleep apnea ;
- liver disease;
- a head injury or seizures;
- urination problems; or
- problems with your thyroid, pancreas, or gallbladder.
If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.
Ask a doctor before using opioid medicine if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.
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