• Adefovir dipivoxil † (Nephrotoxic)
• Alendronate (Avoid in severe renal impairment)
• Allopurinol †
• Aluminum Salts (Avoid in severe renal impairment as may accumulate)
  
• Amphotericin B (Nephrotoxic)
  
• Apomorphine: The manufacturer recommends lower starting doses in mild and moderate renal impairment and that the drug not be used in severe renal impairment
  
• Apremilast: Manufacturer recommends dose reduction in severe renal impairment
• ASA
• Azathioprine †

• Acebutolol †
• Amiloride (Avoid in severe renal impairment)
• Amoxicillin
• Amoxicillin / Clavulanate

• Acamprosate (avoid in severe renal impairment)
• Acetazolamide (Avoid; ineffective when ClCr <10mL/min)
• Acyclovir
• Almotriptan
• Alogliptin (Active metabolites)
• Amantadine
• Amikacin (Nephrotoxic; monitor serum drug concentrations)
• Ampicillin
• Anakinra
• Atenolol 
• Auranofin †

• Bictegravir ( Manufacturer recommends avoiding use if ClCr <30 mL/min)
• Bisacodyl ( Active metabolite but no dosage adjustment required)
• Bivaluridin (Reduce dose in severe renal impairment)
• Brexpiprazole (Manufacturer recommends reducing the dose by 25–33% when ClCr <60 mL/min)
• Bumetanide ( Larger doses may be required in severe renal impairment)
• Bupropion †
• Butalbital †

• Bezafibrate (Avoin in renal impairment)
• Bisoprolol 
• Brinzolamide (Eye drops; contraindicated in severe renal impairment)

• Baclofen
• Baricitinib ( Manufacturer recommends avoiding use if ClCr <60 mL/min)

• Caffeine †
• Canagliflozin (Less effective in moderate and ineffective in severe renal impairment)
• Celecoxib (Nephrotoxic)
• Chloral Hydrate † (Avoid)
• Chlordiazepoxide †
• Cilazapril †
• Cladribine (Not recommended if ClCr <60 mL/min)
• Clarithromycin †
• Codeine †
• Colchicine (Avoid in renal impairment)
• Cyclophosphamide †
• Cyclosporine (Nephrotoxic; monitor serum drug concentrations)

• Captopril 
• Cefixime
• Cefotaxime †
• Cefprozil
• Cetirizine 
• Chloroquine
• Chlorthalidone (Avoid; ineffective when ClCr <30 mL/min)
• Cimetidine
• Ciprofloxacin
• Cyanocobalamine (% renal elimination increased with large doses)

• Cefadroxil
• Cefazolin
• Cefepime
• Cefoxitin 
• Ceftazidime
• Cefuroxime
• Cephalexin
• Chromium
• Cidofovir †
• Clodronate (Avoid, Nephrotoxic)

• Dapagliflozin ( Contraindicated in moderate to severe renal impairment)
• Desloratadine †
• Desvenlafaxine (Manufacturer recommends dosage adjustment if ClCr <30 mL/min, although <50% renal elimination)
• Dexrazoxane (Reduce dose by 50% in patients with moderate to severe renal impairment)
• Dextromethorphan †
• Diclofenac (Nephrotoxic)
• Didanosine †
• Diflunisal (Nephrotoxic)
• Diphenoxylate (Active metabolites)
• Duloxetine (Use contraindicated by the manufacturer if ClCr <30 mL/min)

• Dabigatran ( Contraindicated in severe renal impairment)
• Dalteparin
• Daptomycin
• Deferoxamine 
• Desmopressin
• Dicyclomine
• Digoxin (Monitor serum concentrations)
• Dofetilide 

• Enalapril †
• Eplerenone ( Use contraindicated by the manufacturer if ClCr <30 mL/min)
• Eptifitabide ( Dosage adjustment recommended for patients with renal impairment)
• Esketamine †
• Ethacrynic Acid (Avoid in severe renal impairment)
• Etodolac (Nephrotoxic)

• Edoxaban
• Empagliflozin ( Less effective in moderate and ineffective in severe renal impairment)
• Ertugliflozin (Less effective in moderate, and ineffective in severe renal impairment)
• Ethambutol
• Etidronate (Nephrotoxic)

• Emtricitabine 
• Enoxaparin
• Ertapenem
• Eslicarbazepine
• Eszopiclone
• Exenatide (Avoid in severe renal impairment)

• Famciclovir †
• Fenofibrate †
• Fexofenadine †
• Flecainide †
• Flurbiprofen (Nephrotoxic)
• Folic Acid (% renal elimination increased with large doses)

• Fesoterodine (Active metabolite)
• Fluconazole
• Furosemide ( Larger doses may be required in severe renal impairment)

• Famotidine
• Fampridine ( Use contraindicated by the manufacturer if ClCr <60 mL/min)
• Flucytosine
• Fondaparinux
• Foscarnet (Avoid, Nephrotoxic)

• Galantamine (Manufacturer recommends a maximum daily dose of 16 mg if ClCr <60 mL/min)
• Gemfibrozil †
• Glimepiride †
• Glyburide ( Avoid. Active metabolite but no dosage adjustment required)

• Guanfacine

• Gabapentin
• Ganciclovir
• Gentamicin ( Nephrotoxic; monitor serum drug concentrations)

• Hydrocodone †
• Hydroxychloroquine †

• Hydroxyzine 

• HCTZ (Avoid; ineffective when ClCr <30 mL/min)

• Ibuprofen (Nephrotoxic)
• Indapamide (Avoid; ineffective when ClCr <30 mL/min)
• Indomethacin (Nephrotoxic)
• Isotretinoin (Avoid in renal impairment)

• Imipenem/cilastatin

• Iodine

• Ketoprofen (Nephrotoxic)

• Ketotifen

• Ketorolac (Nephrotoxic)

• Leflunomide †
• Loratadine ( Active metabolite; consider dosage adjustment in severe renal impairment)
• Lurasidone †

• Lamivudine †
• Levetiracetam
• Levomilnacipran

• L-Carnitine
• Lacosamide (Manufacturer recommends a maximum daily dose of 300 mg in patients with end-stage renal disease)
• Levofloxacin
• Lisinopril
• Lithium (Nephrotoxic; monitor serum drug concentrations)

• Magnesium salts (Avoid in severe renal impairment as may accumulate)
• Maraviroc (Modify dose when taking concurrent potent CYP3A4 inhibitors)
• Mefenamic Acid (Nephrotoxic)
• Meloxicam (Nephrotoxic)
• Meperidine †
• Mercaptopurine †
• Methazolamide (Avoid; ineffective in severe renal impairment)
• Methyldopa †
• Midodrine †
• Mirabegron (Manufacturer recommends a maximum daily dose of 25 mg in patients with severe renal impairment)
• Morphine †

• Meropenem
• Methylnaltrexone

• Memantine
• MESNA
• Metformin (Avoid in severe renal impairment)
• Methotrexate (Avoid, Nephrotoxic)
• Metoclopramide †
• Milrinone
• Mirtazapine

• Nabumetone † (Nephrotoxic)
• Naloxegol (Manufacturer recommends 50% reduction of initial dose in moderate or severe renal impairment)
• Naproxen (Nephrotoxic)
• Nebivolol †
• Nitrofurantoin (Avoid in renal impairment)

• Naratriptan
• Nizatidine

• Nadolol
• Nadroparin
• Norfloxacin

• Octreotide (Reduce dose in severe renal impairment)
• Olmesartan (Not recommended in severe renal impairment)
• Orphenadrine †
• Oseltamivir (dosage adjustment recommended in severe renal impairment)
• Oxcarbazepine †

• Penicillamine (Avoid, Nephrotoxic)
• Pentamidine (Nephrotoxic when given IV)
• Perindopril †
• Piroxicam (Nephrotoxic)
• Prochlorperazine †
• Procyclidine †
• Pyrazinamide (Avoid in severe renal impairment)

• Paliperidone (Manufacturer recommends dosage adjustment in renal impairment)
• Pamidronate (Nephrotoxic)
• Penicillin G/V
• Procainamide †
• Prucalopride
• Pyridoxine (% renal elimination increased with large doses)

• Pheniramine
• Piperacillin
• Piperacillin/tazobactam
• Potassium salts (May accumulate in renal impairment)
• Pramipexole
• Pregabalin
• Probenecid (Ineffective when ClCr <50 mL/min)
• Pseudoephedrine

• Quinapril †

• Ramipril †
• Remdesevir (Active metabolite. The excipient betadex sulfobutyl ether may accumulate in severe renal impairment)
• Ribavirin (Avoid in renal impairment)
• Risperidone †
• Rituximab (Nephrotoxic)
• Rivaroxaban (Avoid in severe renal impairment)

• Ranitidine
• Riboflavin

• Risedronate (Avoid in severe renal impairment)

• Saxagliptin †
• Spironolactone † (Avoid)
• Stavudine †
• Sulfinpyrazone (Avoid, Nephrotoxic)
• Sulindac (Nephrotoxic)

• Sacubitril/valsartan
• Solifenacin (Active metabolites)
• Sotalol
• Sulfadiazine (Nephrotoxic)
• SMZ/TMP

• Sitagliptin
• Streptomycin (Nephrotoxic; monitor serum drug concentrations)

• Tadalafil †
• Tapentadol (Not recommended in severe renal impairment)
• Tenoxicam (Nephrotoxic)
• Teriparatide (Do not use if ClCr <30 mL/min)
• Tofacitinib (Manufacturer recommends dosage adjustment in moderate or severe renal impairment)
• Tramadol †
• Trandolapril †
• Tranylcypromine †
• Triamterene (Avoid; nephrotoxic. Active metabolite but no dosage adjustment required)

• Terbinafine
• Tetracycline (Nephrotoxic)
• Tirofiban

• Telbivudine
• Tenofovir (Nephrotoxic)
• Tiaprofenic Acid (Nephrotoxic)
• Tinzaparin
• Tobramycin (Nephrotoxic)
• Topiramate
• Tranexamic Acid
• Trihexyphenidyl
• Trimethoprim

• Valacyclovir †
• Venlafaxine †
• Voriconazole (Avoid IV formulations in renal impairment; nephrotoxic vehicle)

• Valganciclovir † (Nephrotoxic)

• Vancomycin (Nephrotoxic; monitor serum drug concentrations)
• Varenicline
• Vigabatrin
• Vitamin C

• Zidovudine (Reduce dose in severe renal impairment)

• Zoledronic acid

Anti-infectives