A UK clinical pharmacist has shared vital advice for people taking certain medications for blood pressure and diabetes, explaining that continuing these drugs while severely ill can seriously harm the kidneys.
In a popular TikTok video, Anum emphasized the importance of temporarily stopping some medications during episodes of severe vomiting, diarrhoea, fever, or if you’re unable to keep fluids down. Doing so can help prevent acute kidney injury, a potentially dangerous condition.
Medications that often require temporary discontinuation in such situations include ACE inhibitors like ramipril and lisinopril, commonly prescribed to manage blood pressure. Diuretics such as furosemide, diabetic medications including metformin, and SGLT2 inhibitors like dapagliflozin and empagliflozin also fall under this category. Additionally, ARBs (angiotensin receptor blockers) such as losartan and candesartan, as well as common NSAIDs like ibuprofen and naproxen, can increase kidney risk during severe illness.
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Anum advises that patients should only restart these medications once they have fully recovered, are able to eat and drink normally, and have been symptom-free for 24 to 48 hours. However, she stresses the importance of consulting a GP or pharmacist before stopping or restarting any medication.
“Don’t stop insulin or essential meds without advice,” she cautioned. “Always ask your pharmacist or GP if unsure.”
The NHS supports this guidance with its own ‘sick day rules,’ noting that these precautions apply to prolonged illness, not minor or isolated bouts of sickness or diarrhoea. It warns that dehydration and fluid loss during illness pose significant risks for those with conditions such as diabetes, hypertension, or chronic kidney disease, increasing the chances of acute kidney injury and diabetic complications.
Following these ‘sick day rules’ can help reduce complications and protect overall health during periods of severe illness.