ModerateNon-steroidal anti-inflammatory drugs (NSAIDs)×X-ray contrast media. Watersoluble nephrotropic low-osmolar iodinated agents
Updated · Methodology
Mechanism
Additive nephrotoxicity. NSAIDs reduce renal blood flow by suppressing vasodilatory prostaglandin synthesis; contrast adds tubular osmotic load. Contrast-induced AKI risk rises 2–3-fold.
Symptoms
Decreased urine output, rising creatinine, oedema, nausea. Symptoms develop 24–72 hours after contrast.
Management
Stop diclofenac 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 6–12 hours after imaging. Analgesic alternative: paracetamol up to 3 g/day.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- KDIGO: KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of CKD (2024)– Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int 2024;105(4S):S117-S314.