Major
Iopromide × Ketorolac
X-ray contrast media. Watersoluble nephrotropic low-osmolar iodinated agents×Non-steroidal anti-inflammatory drugs (NSAIDs)
Mechanism
Additive nephrotoxicity. Ketorolac (NSAID) suppresses prostaglandin-dependent renal blood flow; iodinated contrast (iopromide) adds osmotic load. High risk of acute kidney injury.
Symptoms
Reduced urine output, rising creatinine, proteinuria. Severe cases include oliguria and need for haemodialysis. Symptoms appear 1–3 days after contrast.
Management
Stop ketorolac 48 hours before planned contrast and resume 48 hours after with stable renal function. Alternative analgesics: paracetamol, metamizole, or a short opioid course. Provide contrast nephroprotection with adequate saline hydration.
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.