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