A UK clinical pharmacist has issued a vital health warning, sharing essential 'sick day rules' for people taking common medications for conditions like high blood pressure and diabetes. The guidance highlights that continuing with certain prescriptions during severe illness can dramatically increase the risk of acute kidney injury.
Which Medications Require a Pause?
In a TikTok video, pharmacist Anum outlined specific drug types that patients may need to stop temporarily if they experience severe sickness. This includes episodes of diarrhoea, vomiting, fever, or an inability to keep fluids down.
The key medication classes identified are:
- ACE inhibitors like ramipril and lisinopril, commonly prescribed for hypertension.
- Diabetes medications such as metformin and SGLT2 inhibitors (e.g., dapagliflozin, empagliflozin).
- Diuretics (water pills) including furosemide.
- ARBs (Angiotensin II Receptor Blockers) like losartan and candesartan.
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen and naproxen.
The core principle is that dehydration from illness, combined with the effects of these drugs, can place excessive strain on the kidneys, potentially leading to sudden damage.
When to Stop and When to Restart
Anum stressed that these rules apply to acute, severe illness and not to minor, one-off episodes. The NHS supports this, clarifying the advice is for longer periods of sickness where significant fluid loss is a risk.
If you meet the criteria of severe illness, the pharmacist advises temporarily stopping the listed medications. Crucially, you should only restart taking them once you have felt better and have been eating and drinking normally for at least 24 to 48 hours.
The Golden Rule: Always Consult a Professional
Both Anum and the NHS issue a critical caveat: patients must never stop essential medications like insulin without first seeking professional advice.
"Don't stop insulin or essential meds without advice," Anum warned. "Always ask your pharmacist or GP if unsure!" This step is non-negotiable, as abruptly stopping some treatments can be dangerous.
The underlying message reinforces that while these 'sick day rules' are a powerful tool for preventing kidney injury during illness, they must be applied cautiously and in consultation with a healthcare expert who understands your personal medical history.
