Ask the Pediatrician

Q: My daughter plays soccer and occasionally takes ibuprofen. Is it bad for her kidney’s?

A. Medications like ibuprofen (Motrin, Advil) and naproxen (Aleve) are nonsteroidal anti-inflammatory drugs, or NSAIDs, and are effective at treating pain and inflammation from minor injuries, as well as reducing fever. They are generally safe if used infrequently. But using these medications in high doses, or using them regularly for an extended period of time, may be harmful.

NSAIDs reduce fever, pain and inflammation by reducing the body’s production of chemicals called prostaglandins. Prostaglandins help to regulate blood flow in many parts of the body, and NSAIDs in large doses – especially when given regularly – can reduce blood flow through the kidneys. Prolonged use can harm the kidneys and is especially harmful if blood flow to the kidneys is already reduced by dehydration. This can happen during the summer, when children are exercising and sweating, or when children are sick with vomiting and diarrhea.

To avoid harmful reactions: Make sure your child is well hydrated while taking NSAIDs. A guideline for how much fluid your child needs is to drink enough water to make the urine colorless or slightly yellow. During exercise or athletic participation, especially in the summer, your child should drink 4 to 8 ounces for every 15 minutes of activity. Water is the ideal beverage for hydration, but during prolonged vigorous activity that leads to sweating, sports beverages may be appropriate to replace electrolytes.

Talk to your child’s doctor about frequent NSAID use. Needing to take these medications on a regular or even constant basis for pain or fever could be a sign of a more serious health problem. Telling your doctor how frequently your child needs these medications may help determine if further evaluation or testing is needed.

Follow dosage instructions. And be aware that ibuprofen is not recommended for infants under 6 months of age, and naproxen is not recommended for children under age 12.