During acute illness with vomiting, diarrhoea, fever or poor oral intake, several common drugs raise the risk of acute kidney injury or metabolic complications. These include ACE inhibitors, angiotensin receptor blockers, diuretics, SGLT2 inhibitors, metformin and NSAIDs.
Many services advise patients to pause these temporarily while they cannot eat and drink normally, and restart within a day or two of recovery. Give the advice in writing, with clear instructions on when to seek help.
- Give written sick-day advice to patients on ACE inhibitors, ARBs, diuretics, SGLT2 inhibitors or metformin
- Advise pausing these during vomiting, diarrhoea or poor intake
- Restart once eating and drinking normally, usually within 24 to 48 hours
- Tell patients to avoid NSAIDs and to seek review if they cannot keep fluids down
Why it matters
Simple advice can prevent avoidable acute kidney injury during intercurrent illness.
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