Ibuprofen × Iopromide

Additive nephrotoxicity. NSAIDs reduce renal blood flow by suppressing vasodilatory prostaglandin synthesis; contrast adds tubular osmotic load. Contrast-induced AKI risk rises.

Decreased urine output, rising creatinine, oedema, nausea. Symptoms develop 24–72 hours after contrast.

Stop ibuprofen 24–48 hours before elective contrast imaging; restart 48 hours after the study once creatinine normalises. With creatinine clearance below 60 mL/min, give IV isotonic hydration 6–12 hours before and after imaging. Alternative: paracetamol up to 3 g/day.