meloxicam × tacrolimus

NSAID (meloxicam) + nephrotoxic calcineurin inhibitor (tacrolimus) – additive acute kidney injury risk in transplant patients.

Reduced urine output, rising creatinine and potassium, oedema. Symptoms appear earlier in older patients and chronic kidney disease.

Avoid prolonged combination. For post-transplant analgesia: paracetamol (up to 2 g/day) or a short opioid course. For neuropathic pain: gabapentin or pregabalin.