celecoxib × tacrolimus

Celecoxib (a selective COX-2 inhibitor) reduces renal blood flow via prostaglandin suppression. Tacrolimus is nephrotoxic in its own right. Additive acute kidney injury risk, especially with borderline renal function.

Reduced urine output, rising creatinine, potassium accumulation. In kidney transplant patients: accelerated graft function decline.

Avoid chronic celecoxib on tacrolimus. For analgesia post-transplant, use paracetamol (up to 2 g/day) or a short opioid course. For neuropathic pain, gabapentin or pregabalin. Check creatinine monthly.