Medications for Chronic Kidney Disease
Medications for
Classes of Medications
Diuretics, electrolyte supplements, alkalinsing agents
Diuretics (“Water pill”)
Frusemide, Hydrochlorothiazide,
Indapamide, Metolazone, Spironolactone
Potassium chloride
Sodium chloride
Sodium bicarbonate
Uric acid lowering agents
Xanthine oxidase inhibitors
Allopurinol, Febuxostat
Medications for anemia
Erythropoiesis-stimulating agents
Darbepoetin Alfa, Erythropoietin, Methoxy
polyethylene glycol-epoetin beta
Iron and vitamins supplements
Iron, Folic acid, Vitamin B12
(Cyanocobalamin, Mecobalamin)
Medications for Chronic Kidney Disease – Mineral and Bone Disorder (CKD-MBD) and secondary hyperparathyroidism (SHPT)
Phosphate binding agents
Aluminium Hydroxide, Calcium Carbonate,
Sevelamer
Calcium supplement
Calcium Carbonate
Vitamin D preparations
Alfacalcidol, Calciferol, Calcitriol,
Cholecalciferol, Paricalcitol
Medications for secondary
hyperparathyroidism
Cinacalcet
Others
Please refer to related patient information leaflets for medication treatments of high blood pressure, high cholesterol level and diabetes mellitus.
※ If you experience sleepiness, dizziness or blurred vision after taking the medications, avoid driving or activities requiring mental alertness or coordination. Avoid alcohol as it may increase the side effects.
※ If you notice any allergic reactions like skin itchiness, face or hand swelling, breathing difficulty, etc., consult your doctor immediately.
Common side effects
Dizziness, stomach upset
Potassium chloride: Stomach upset, diarrhoea
Sodium chloride: Nausea, vomiting, stomach
upset
Muscle cramps, urinary urgency, loss of
appetite, headache, oedema
Stomach upset, dizziness , nausea, diarrhoea,
skin rash
High blood pressure, seizure, headache,
oedema, abdominal pain, cough
Iron: Darkening of stool, stomach upset,
constipation
Folic acid: Stomach upset
Vitamin B12: Stomach upset
Aluminium Hydroxide / Calcium Carbonate:
Constipation, nausea, vomiting, stomach upset
Sevelamer: Nausea, vomiting, diarrhoea,
indigestion
Constipation, abdominal pain, flatulence,
nausea, vomiting
Headache, nausea, vomiting, constipation,
diarrhoea
Nausea, vomiting, diarrhoea, headache,
abdominal pain, dyspnea, muscle pain,
weakness, tingling sensation
Precautions
Chronic Kidney
Disease
※ To avoid frequent urination at night, diuretics should preferrably be taken in the morning for daily dose. For twice daily dosing, take the second dose six to eight hours after the first dose.
※ Diuretics may affect potassium level in blood, do not use any potassium-containing medications, supplement or potassium salt substitutes without consulting your doctor.
※ Take with food to reduce stomach upset.
※ Consult your doctor if muscle twitching or weakness occurs during the therapy.
※ Potassium chloride or sodium chloride is used as a supplement to dietary inadequacy and potential loss due to diuretics or renal replacement therapy. It is prescribed by doctor with regular monitoring of
blood potassium or sodium level.
※ Do not use any potassium salt substitutes or increase the dosage of potassium chloride without consulting your doctor. It may cause high blood potassium level and possible side effects.
※ Maintain dietary salt restriction to prevent high blood sodium level and possible side effects.
※ Take with meals to reduce stomach upset.
※ Potassium chloride: Swallow the tablet whole with plenty of water; do not crush or chew the tablet.
※ Sodium bicarbonate is prescribed by doctor for the treatment of disorders related to acid-base imbalance.
※ Avoid taking the drug together with dairy products.
※ Take allopurinol with or after meals to reduce stomach upset.
※ Avoid alcohol and excessive intake of vitamin C to reduce the risk of kidney stone formation.
※ Stop taking the medication and consult your doctor immediately if skin rash occurs.
※ Monitor blood pressure and pulse regularly while on long term therapy. Consult your doctor if high blood pressure, severe headache, rapid heartbeat, or chest pain occurs during the therapy.
※ This medication may cause seizures. Do not operate heavy machinery or engage in high risk activities that need full attention.
※ Store in refrigerator; do not freeze.
※ Do not shake.
Iron:
※ Take with or after meals to reduce stomach discomfort.
※ Iron tablets can either be chewed or swallowed whole depending on the iron formulation prescribed to you. For the best treatment effect, please read the instructions on label before taking.
※ Increase fibre (e.g. vegetables) intake to prevent constipation.
※ Take with meals to enhance binding of phosphate in food and limit intestinal phosphate absorption.
※ Calcium carbonate and aluminium hydroxide tablets can either be chewed or swallowed whole depending on the formulation prescribed to you. For the best treatment effect, please read the instructions on
label before taking.
※ Sevelamer: Swallow whole; do not crush or chew. Take with meals.
※ Calcium carbonate tablets can either be chewed or swallowed whole depending on the formulation prescribed to you. For the best treatment effect, please read the instructions on label before taking.
※ Do not use any vitamin D without consulting your doctor.
※ Take with food or shortly after a meal.
For any queries,
※ Swallow whole; do not crush or chew.
※ Consult your doctor immediately if vomiting, weakness, muscle pain, muscle spasm, seizure or abnormal
skin sensation occurs during the therapy.
please seek advice from your doctor,
pharmacist or other healthcare
professionals.
藥劑職系及服務統籌委員會
COC-Grade (Pharmaceutical Services)
S/N: 017Ev2 (10/2020)
認識抗慢性腎臟疾病藥 忘記用藥處理方法 腎 臟 科 藥 物 之
抗慢性腎臟
藥類 常見副作用 注意事項 應儘快補用適量的劑量，若記起時已接近使用下
利尿藥（俗稱去水丸） 暈眩、胃部不適 ※ 如每日一次，應在早上服用；如每日兩次，第二劑應在六至八小時後服用。以避免晚上排尿頻密影響睡
Frusemide, 眠。 一劑量的時間，便不必補用，只需依時使用下一
Hydrochlorothiazide, ※ 利尿藥能影響血液中的鉀含量，未經醫生指示，不要隨意使用含鉀的藥物、補充劑或代鹽 。 劑量。

疾病藥
利 Indapamide, Metolazone, ※ 與食物同服可減輕胃部不適的副作用。
尿 Spironolactone
及 ※ 如出現肌肉抽搐或身體虛弱無力等症狀，應告知醫生。
保
持 鉀劑 鉀劑 : 胃部不適、腹瀉 ※ 補充因進食吸收不足、服用利尿藥或透析所引致的鉀質或鈉質流失。必須經驗血後由醫生處方才可服 切勿使用雙倍的劑量。
電 Potassium chloride 用。
解 ※ 未經醫護人員指示，不要隨意使用含鉀的代鹽或增加鉀劑的劑量，以免血液中的鉀含量過高，引致副作
質 鈉劑 : 噁心、嘔吐、胃部不
和 鈉劑 適 用。
酸 ※ 限制從飲食吸收的鹽含量，以免血液中的鈉含量過高，引致副作用。
鹼 Sodium chloride
平 ※ 進餐時服用鉀劑或鈉劑可減輕胃部不適的副作用。
衡
藥
※ 需以足夠的水分送服。鉀劑藥丸應整粒吞服，請勿咬碎或磨碎藥丸。 貯存藥物須知
鹼化劑 肌肉抽搐、增加排尿意慾、 ※ 治療系統性酸中毒，必須經醫生處方才可服用。
Sodium bicarbonate ( 俗 稱 梳 食慾不振、頭痛、水腫 ※ 不要與奶類食品同服。
打丸 )
把藥物存放在陰涼乾爽的地方，避光保存。
降 黃嘌呤氧化酶抑制劑 胃部不適、暈眩、噁心、腹 ※ 進餐時或餐後服用 Allopurinol 可減輕胃部不適。
尿 Allopurinol, Febuxostat 瀉、皮疹 ※ 避免飲酒及服用過多維他命 C，以減低腎結石形成的風險。
酸 ※ 若皮膚出現皮疹，應停服及立即求醫。
把藥物存放在孩童不能觸及的地方。
藥

紅血球生成素（俗稱補血針） 血壓升高、抽筋、頭痛、水 ※ 長期使用時，應定期量度血壓與脈搏。如發現血壓上升、嚴重頭痛、心跳加速或胸口疼痛，應立即告知 過期或完成療程後剩餘之藥物應立即棄掉。

Darbepoetin Alfa, 腫、腹痛、咳嗽 醫生。
Erythropoietin, Methoxy ※ 由於此藥有機會引致抽筋，應避免操作大型機械或參與有危險性的活動。
polyethylene glycol-epoetin ※ 存放於雪櫃，但勿放在冰格內。 切勿與他人共用藥物。
抗 beta
貧
※ 不可搖勻。
血 鐵質及維他命 鐵劑 : 糞便色澤變深、胃部 鐵劑：
藥
鐵劑 Iron 不適、便秘 ※ 進餐時或餐後服可減輕胃部不適。

葉酸 Folic acid 葉酸 : 胃部不適 ※ 服用鐵劑前，應根據藥物標籤了解藥物是否需要整粒吞服或咬碎服用，以達到最佳的治療效果。

維他命 B12 Cyanocobalamin, 維他命 B12: 胃部不適 ※ 多吃高纖維食物（如蔬菜）可減輕便秘的副作用。

Mecobalamin

礦 磷結合劑（俗稱降磷藥） 鋁 / 鈣劑：便秘、噁心、嘔 ※ 進餐時服用可增加藥物對食物中磷質的結合，減少腸道吸收磷質。

物 鋁劑 Aluminium Hydroxide 吐、胃部不適 ※ 服用鈣劑或鋁劑前，應根據藥物標籤了解藥物是否需要整粒吞服或咬碎服用，以達到最佳的治療效果。
質
與 鈣劑 Calcium Carbonate, Sevelamer: 噁心、嘔吐、腹 ※ Sevelamer 須整粒用水吞服，請勿咬碎。需與食物同服。
骨 Sevelamer 瀉、消化不良
骼
代 鈣質補充劑 便秘、腹痛、胃氣脹、噁心、 ※ 服藥前應根據藥物標籤了解藥物是否需要整粒吞服或咬碎服用，以達到最佳的治療效果。
謝 鈣劑 Calcium Carbonate 嘔吐
異
常 維他命 D 類藥物 頭痛、噁心、嘔吐、便秘、 ※ 未經醫生指示，切勿自行購買維他命 D 服用。
及
抗 Alfacalcidol, Calciferol, 腹瀉
副 Calcitriol, Cholecalciferol,
甲 Paricalcitol
狀
腺
如有疑問，
抗副甲狀腺亢進藥 噁心、嘔吐、腹瀉、 頭痛、 ※ 與食物同服或餐後立即服用。
亢 腹痛、呼吸困難、肌肉疼痛
進 Cinacalcet
乏力、皮膚刺痛
※ 應用水整粒吞服，切勿咬碎或磨碎藥丸。 請向你的醫生、藥劑師或有關的醫護人員
藥 ※ 服藥期間如有嘔吐、無力、肌肉疼痛、肌肉痙攣、抽筋、皮膚感覺異常等症狀，請立即求醫。
其
他
有關降高血壓藥、降膽固醇藥及降血糖藥的資料，請參閱有關單張。
查詢。
※ 用藥後如有嗜睡、暈眩或視力模糊等副作用，切勿駕駛或從事需高警覺性的工作；避免飲酒，因酒精可加強此等副作用。
藥劑職系及服務統籌委員會
※ 若於使用藥物後出現過敏反應如皮膚痕癢、面部或手部腫脹、呼吸困難等，請立即求醫。
S/N: 017Cv6 (10/2020) COC-Grade (Pharmaceutical Services)

What is Chronic Kidney Disease
Kidney is a vital organ in the human body, and has the following
functions:
1. Removes excessive water and toxic substances (e.g. urea,
uric acid, etc.) through urine; maintains electrolytes balance
(e.g. sodium and potassium, etc.) and acid-base balance.
2. Produces different types of hormones to regulate blood
pressure and to produce red blood cells.
3. Activates Vitamin D to maintain normal calcium level in bones
for bone health.
Chronic kidney disease occurs when the kidney tissue is
damaged slowly, resulting in progressive loss of kidney function.
Common causes of chronic kidney disease include high blood
pressure, diabetes mellitus, inflammation of the glomeruli
(kidney’s filtering units). Appropriate intake of protein, avoiding
excessive salt and high cholesterol food intake can help to
maintain kidney function and slow down disease progression.
Most people with chronic kidney disease do not have any
noticeable symptoms in early stage. The disease may be
discovered in health checks or when symptoms arise from
declining renal function. Symptoms of chronic kidney disease
include:
1. Malfunction in water and toxic waste substance excretion,
electrolyte and acid-base regulation, which may lead to:
frequent urination at night, blood in urine, protein in urine, high
urea in blood known as uremia (symptoms include nausea,
vomiting, loss of appetite, tiredness, pale face, metallic taste
in mouth, urine-like breath odor, shortness of breath, mental
status changes, itchiness, muscle cramps, etc.) and oedema.
Excessive retention of water in the body may affect the normal
function of the heart (e.g. leading to high blood pressure, heart
failure, etc.) and lead to accumulation of fluid in the lungs and
thereby breathing difficulty.
2. Failure to produce different types of hormones by the kidneys
may lead to high blood pressure and anemia. Patients with
anemia may appear pale, complain of fatigue and loss of
appetite.
3. Kidney disease reduces the ability in removing excessive
phosphate through urination. Accumulation of phosphate and
impaired vitamin D activation may reduce calcium absorption,
thereby causing inadequate calcium level in bones, and
resulting in bone pain and fracture.
Chronic kidney disease cannot be cured completely. Long term
dietary control and medication therapies are the keys to alleviate
symptoms. Progressive decline of renal function may lead to
end-stage kidney failure.
Slowing down the progression of
kidney disease
Undergo regular health check especially in patients with
high blood pressure, diabetes mellitus, high cholesterol level
and other kidney diseases.
Maintain a healthy lifestyle. Follow medical advice strictly
regarding diet and medicines to optimize control of blood
pressure, sugar and cholesterol at goal levels.
Follow your dietitian’s recommendations on dietary control
of protein, sodium, potassium and phosphorus and keep the
right balance of nutrients and fluid.
Precautions on medication use
Use the medications as directed. Do not stop using the
medications or change the dose or frequency unless
directed by your doctor.
Use the medications preferably at the same time every day.
If you have history of drug allergy, consult your doctor or
pharmacist before using the medications.
Tell your doctor and pharmacist if you are pregnant, planning
to become pregnant or breastfeeding.
Medications are mainly broken down and excreted by
your kidneys and liver. If your kidneys do not work well,
medications may accumulate in your body and thus increase
the risk of experiencing side effects. Consult your doctor or
pharmacist before using any other medications, including
health supplements, Traditional Chinese Medicines,
Proprietary Chinese Medicines and over-the-counter
medications.
Please consult your doctor or pharmacist if you encounter
any difficulties in using the medications.
Please consult your doctor if symptoms persist or worsen
after using the medications.
How to store?
Store in a cool, dry place and away from direct heat and
light.
Keep out of reach of children.
Discard all medications that have expired or are no longer
required.
Do not share the medications with other people.
Pharmacist’s advice on appropriate
medication use
Self-discontinuation or dosage adjustment,
because:
• chronic kidney disease cannot be cured completely;
there is no need to use medications.
• of the belief that chronic kidney disease has been
cured after signs and symptoms are relieved.
Although chronic kidney disease cannot be
cured completely, long-term dietary control and
medication therapies can help alleviate the signs
and symptoms (e.g. anemia, uremia and bone
complications) and control the predisposing
factors (e.g. high blood pressure, diabetes
mellitus, high cholesterol level), thereby reducing
the burden on the kidneys and preventing further
deterioration of chronic kidney disease. Patients
with chronic kidney disease often need to comply
with demanding lifestyle and dietary restriction. If
patients maintain good compliance with dietary
control and medication therapy, as well as achieve
strict control of blood pressure, blood sugar
and blood lipid, it may slow down the disease
progression.
What if I miss a dose?
Use the missed dose as soon as you remember. Skip the missed
dose if it is almost time for your next scheduled dose.
Do not double the dose.
Self-medication, because of:
• feeling unwell (e.g. cold or flu) before the next follow-
up visit.
• claim from my friends / relatives that they are good
for the kidneys.
Do not self-medicate with over-the-counter
medications because this is risky to patients
with kidney diseases. Certain medications and
the usual recommended dosages may not be
suitable for your condition. Moreover, patients
with kidney diseases usually take multiple
medications. Self-medicating may potentially lead
to drug-drug interactions. Consult your doctor or
pharmacist before using any other medications,
including health supplements, Traditional Chinese
Medicines, Proprietary Chinese Medicines and
over-the-counter medications.
Refuse to use medications because of potential
side effects.
Not everyone will experience side effects after
using the medications. The severity of side
effects also differs among individuals. You should
not be too worried about the side effects of the
medications. If you stop using the medications
or change the dose or frequency due to potential
side effects, your condition may get worse. Most
common side effects are mild and will subside
when your body adapts to them. Consult your
doctor or pharmacist if the side effects persist or
worsen.
甚麼是慢性腎臟疾病 減慢腎衰竭惡化 藥劑師教你認識正確的用藥觀念

腎臟是人體內一個重要器官，具多種功能，其中 在患病初期，患者不會有明顯的症狀，患者可能 定期作身體檢查，特別是高血壓、糖尿病、

自己停藥或調校劑量，因為：
包括： 在腎功能嚴重衰退或進行身體檢查時才發現已經 高膽固醇及其他腎病患者。 ●
既然慢性腎臟疾病是不能根治的，便不想
患病。慢性腎臟疾病的症狀跟以上的腎功能出現 用藥。
必須按指示定時用藥和保持健康的飲食及生
(1) 把體內過多的水分及有害物質（如尿素、尿酸 失調有關，包括： ●
用藥後病徵得以紓緩，便相信腎病已痊
活習慣，嚴謹地控制血壓、血糖及膽固醇於 癒。
等）通過尿液排出；維持體內的電解質（如鉀、
理想水平。
鈉等）及酸鹼平衡。 （1） 排泄水分及有害物質的功能失調、電解質 雖然慢性腎臟疾病不能根治，但接受長期飲
及酸鹼失平衡，有可能引致夜尿頻密、血 按照營養師的指示，控制蛋白質、鹽、鉀、 食及藥物治療可幫助紓緩病徵（如貧血、尿
毒症及骨患）及控制誘因（如高血壓、糖尿
(2) 分泌各種荷爾蒙以調節血壓及製造紅血球。 尿、蛋白尿（小便含蛋自質）、 尿毒血症 磷質及水分的攝取量，但同時吸取足夠營養。
病及高膽固醇），從而減輕腎臟的負擔，避
（症狀包括噁心、嘔吐、食慾不振、疲倦、 免腎病進一步惡化。腎病患者確實有許多生
(3) 活化維他命 D 以維持骨內的鈣含量正常，令 臉色蒼白、口腔有金屬味、呼吸含尿味、 活及飲食上的限制，但如能積極地面對，控
制飲食，按時用藥，不自行調校劑量，並嚴
骨骼強健。 氣喘、神智不清、皮膚痕癢、抽搐等）及
服藥應注意的事項 謹地控制血壓、血糖及血脂水平，是可以延
水腫。體內積聚過多的水分會影響心臟功 遲腎病的惡化。
當腎臟組織受到長期破壞，令腎功能慢慢減弱， 能（如引致高血壓、心臟衰竭等）及導致
按指示定時用藥，切勿擅自停藥或更改藥物 自己買藥使用，因為：
便稱為慢性腎臟疾病。形成慢性腎臟疾病的成因 肺積水，令呼吸困難。
劑量或用藥次數。 ●
出現小毛病（如傷風感冒等），但未到下
有很多，較普遍的包括高血壓、糖尿病、腎小球 次覆診日期。
腎炎等。適當的飲食，控制蛋白質攝取份量，避 （2） 腎臟的荷爾蒙分泌失調有可能導致高血壓 儘量在每天同一時間用藥。 ●
是親友介紹的，聽說對補腎非常有效。
免進食過量鹽份及高膽固醇的食物，有助保持腎 或貧血。貧血會令病者感到疲倦無力、面
如果曾對藥物有過敏反應，請先向醫生或藥 切勿自行買藥使用，因為這對腎病患者是有
功能，延緩病情惡化的速度。 色蒼白及食慾不振。 一定風險。部份藥物或一般藥物劑量是不適
劑師查詢。
用於腎病患者。而且，腎病患者通常要使用
（3） 腎衰竭會引致多餘的磷質不能經尿液排出。 多種藥物，擅自使用其他藥物，有可能引致
懷孕、計劃懷孕或餵哺母乳的婦女在用藥前
藥物之間產生相互作用。故未經醫生或藥劑
過多的磷質會降低鈣質吸收及阻礙維他命 請先告知醫生和藥劑師。 師指示，切勿隨便使用其他藥物，包括保健
D 的活化過程，導致骨內鈣含量失調而引 產品、中藥、中成藥或西藥。
致骨患，出現骨痛及骨折。 藥物主要是經肝及腎分解後排出體外。當腎
功能衰退，體內容易積聚過多的藥物，增加 害怕藥物的副作用，不肯用藥。

慢性腎臟疾病是不能根治的，治療方式主要是透 出現副作用的機會。故未經醫生或藥劑師指 不是每個人用藥後都會出現副作用，而副作

示，切勿隨便使用其他藥物，包括保健產品、 用的嚴重程度亦因人而異，毋須過份擔心。
過控制飲食及使用藥物，以減輕由腎病引致的症
中藥、中成藥或西藥。 如因害怕藥物的副作用而擅自更改劑量或停
狀；當病情嚴重時，腎功能會逐漸喪失，演變為 藥，有機會令病情惡化，後果更為嚴重。一
末期腎病。 將用藥上的困難告知醫生或藥劑師，讓他們 般的副作用均屬輕微，並會隨身體的適應而
逐漸減退。若副作用持續影響日常生活或情
了解你的情況，以便作出跟進。 況惡化，便需告知醫生或藥劑師，以便作出
跟進。
用藥後如果情況持續或惡化，應立即求醫。