Medicines for people having dialysis

Medicines can be used to help with your symptoms if you are having haemodialysis or peritoneal dialysis. This page aims to give you more information about some of your most commonly prescribed medicines and some of their possible side effects. For more information, ask your doctor or pharmacist.

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What types of medicines might I need?

Some of the most common medicines that you may be prescribed include:

Medicines that reduce itching

Itching is a common symptom of CKD which can happen as waste products build up in your body. Antihistamines are often suggested to help; there are many types available, and some can be bought from your pharmacist. Make sure you don’t take more than the recommended dose.

However, the mechanism of itching associated with kidney disease is different from allergic itching, so antihistamines are usually not effective. Gabapentin, pregabalin and difelikefalin are drugs that your doctor might consider prescribing for CKD-related itch. Note: many of these medications may make you drowsy.

Medicines that relieve constipation

Lactulose, senna, docusate or Fybogel® are given to treat or prevent constipation. They can be taken once or twice a day. They may take a day or so to be effective. Side effects include belching or stomach cramps. Note: these are commonly prescribed to patients on peritoneal dialysis. Fybogel® should not be taken if you are on a fluid restriction.

Medicines to treat infections caused by bacteria

Haemodialysis patients may need antibiotics to treat any haemodialysis line infections. Antibiotics, including gentamicin and vancomycin, can be given into your bloodstream. They are usually given as an injection during dialysis and blood levels need to be measured. Other antibiotics may be used depending on the bacteria involved.

Peritoneal dialysis patients may suffer with peritonitis – an infection of the thin inner lining of the abdomen. Antibiotics, including gentamicin, vancomycin and ciprofloxacin, may be used to treat this, usually given as a course of treatment, directly into your bloodstream through a needle into your arm, or into the dialysis fluid. Blood levels may need to be measured to see when another dose is needed. Other antibiotics may be used depending on the bacteria involved.

Medicines to prevent clotting while you are having haemodialysis

Medicines such as heparin or low-molecular weight heparin (for example, dalteparin, enoxaparin) are used to thin your blood to allow it to pass easily through the dialysis machine without clotting. The dose will be adjusted depending on your weight and if you have problems with clotting or bleeding on haemodialysis.

Medicines to stop blocks in your haemodialysis catheter

At the end of dialysis, a solution will be injected into your haemodialysis catheter to prevent blood clotting and infections. It stays there until the next haemodialysis session. There are different types of solutions which contain antibiotics (Taurolock®), citrate (Citra-Lock®) or heparin.

Hepatitis B vaccination

You are advised to have hepatitis vaccinations before you start needing dialysis. This is a viral infection spread through infected blood or bodily fluids, so dialysis increases the risk slightly.

Medicines to treat cramps

Sometimes dialysis patients suffer with cramps. Cramp can be caused by taking large amounts of fluid off on haemodialysis or by not having enough fluid in your bloodstream, for example coming off dialysis below your dry weight.

Your dry weight may be adjusted if you have lost body (flesh) weight to help with this. Speak to your dialysis nurse about your weight if you have any concerns. If you are putting a lot of weight on between haemodialysis sessions, watch your fluid intake and have a chat with your dietitian about ways to reduce the amount of water you drink.

Medicines to relieve pain

Paracetamol is fine for all CKD patients to take. Co-codamol or co-dydramol are also safe, but you may need a smaller dose.

Anti-inflammatory tablets such as ibuprofen (Nurofen®) and high-dose aspirin may sometimes be used with care by patients on dialysis, if you no longer produce any wee (urine). Talk to your kidney doctor or pharmacist before taking non-steroidal anti-inflammatory drugs (NSAIDs).

Where can I find more information?