Major
Iopromide × meloxicam
X-ray contrast media. Watersoluble nephrotropic low-osmolar iodinated agents×NSAID, COX-2 preferential, oxicam derivative
Mechanism
Similar to iopromide + naproxen. Contrast and NSAID – additive nephrotoxicity.
Symptoms
Reduced urine output, rising creatinine and potassium, oedema. Symptoms appear earlier in older patients and chronic kidney disease.
Management
Stop meloxicam 48 hours before planned contrast and resume 48 hours after with stable renal function. Alternative analgesic: paracetamol. Provide contrast nephroprotection with adequate hydration.