Major
Iopromide × naproxen
X-ray contrast media. Watersoluble nephrotropic low-osmolar iodinated agents×NSAID, propionic acid derivative
Mechanism
Contrast and NSAID (naproxen) – additive nephrotoxicity, especially in chronic kidney disease and dehydration.
Symptoms
Reduced urine output, rising creatinine and potassium, oedema. Symptoms appear earlier in older patients and chronic kidney disease.
Management
Stop naproxen 48 hours before planned contrast and resume 48 hours after with stable renal function. Alternative analgesic: paracetamol. Provide contrast nephroprotection with adequate saline hydration.