Moderate
Amlodipine × meloxicam
Calcium channel blockers (dihydropyridines)×NSAID, COX-2 preferential, oxicam derivative
Mechanism
NSAIDs antagonise amlodipine's antihypertensive effect via renal prostaglandin-dependent sodium regulation suppression.
Symptoms
Gradual blood pressure rise 1–2 weeks after starting meloxicam. In chronic kidney disease: fluid retention and oedema risk.
Management
For short meloxicam courses (5–7 days), monitor blood pressure. For chronic analgesia: switch to paracetamol or celecoxib (with PPI cover).