Avoiding nephrotoxic medications is critical in managing chronic kidney disease (CKD) to prevent further renal injury. Common drugs like NSAIDs, certain antibiotics (e.g., aminoglycosides, nitrofurantoin), and over-the-counter remedies can harm already compromised kidneys and should be minimized or avoided. Metformin, SGLT2 inhibitors, baclofen, and gabapentin require dose adjustments or discontinuation in advanced CKD due to accumulation and toxicity risks. Even widely used drugs like proton pump inhibitors and digoxin can contribute to CKD progression or toxicity if not closely monitored. Regular medication reviews and careful prescribing—especially of OTC and renally cleared medications—are essential to protect kidney function.