MajorNon-steroidal anti-inflammatory drugs (NSAIDs)×Calcineurin inhibitor (immunosuppressant)
Updated · Methodology
Mechanism
Diclofenac (NSAID) suppresses renal prostaglandin synthesis maintaining glomerular perfusion. Tacrolimus is nephrotoxic in its own right. Additive acute kidney injury risk in transplant patients.
Symptoms
Reduced urine output, rising creatinine, potassium accumulation. In kidney transplant patients: accelerated graft function decline.
Management
Avoid chronic diclofenac on tacrolimus. For analgesia post-transplant, use paracetamol (up to 2 g/day) or a short opioid course. For neuropathic pain, gabapentin or pregabalin.
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
- FDA: Prograf (tacrolimus) prescribing information (2013)– ; DailyMed setid 7f667de1-9dfa-4bd6-8ba0-15ee2d78873b
- AEMPS: Ficha técnica: Diclofenaco (nº registro 62161), sección 4.5 (2025)– AEMPS, CIMA, nº registro 62161, revisión 08/2025, sección 4.5