OTC cold and flu medications may contain several active ingredients in one formula, some of which may not be safe for people with FSGS.
For example, oral decongestants like pseudoephedrine and phenylephrine can raise blood pressure and affect the kidneys.
Some combination medications also contain NSAIDs, which can further damage the kidneys.
Safe to Use
Safer OTC cold, flu, and allergy medications, according to Gershman and Ngo-Hamilton, include:
- dextromethorphan (such as Delsym)
- guaifenesin (such as Mucinex)
- loratadine (such as such as Claritin)
- cetirizine (such as Zyrtec)
- fexofenadine (such as Allegra)
For nasal congestion, saline nasal sprays, which are available OTC, are a good option because they usually contain no medication and don’t affect the kidneys or blood pressure, says Ngo-Hamilton.
For fever and body aches, acetaminophen remains the safer OTC option, but check labels carefully because acetaminophen is found in many cold and flu combination products.
Taking more than one product with acetaminophen can increase the risk of liver problems, especially if you exceed the recommended daily dose, Ngo-Hamilton says.
Some of these medications may require dose adjustments depending on your kidney function.
This is one reason why it’s important to check with your nephrologist or pharmacist before starting any new medication.
Avoid
Oral decongestants to avoid, Diaz says, include:
- pseudoephedrine (Sudafed)
- phenylephrine (Sudafed PE)
You should also avoid combination cold and flu medications that contain these oral decongestants, Diaz says. These include:
- DayQuil Cold & Flu
- Theraflu Daytime Severe Cold and Cough
If you take an antihistamine for allergies, stick to the plain formula. Products with a D in the name, such as Allegra-D, Claritin-D, and Zyrtec-D, contain an oral decongestant and should be avoided.
Ngo-Hamilton recommends avoiding combination cold and flu medications that contain NSAIDs, such as:
- Advil Cold and Sinus
- Advil Multi-Symptom Cold and Flu
- Sudafed Sinus 12-Hour Pressure + Pain
Ask Your Doctor First
Diphenhydramine (Benadryl) is generally safe for most people with FSGS but should be used with caution, says Diaz, because it can cause urinary retention (the inability to completely empty your bladder) and prolonged drowsiness in people with more advanced chronic kidney disease.
Ask your nephrologist whether it’s appropriate before using it.
