MajorX-ray contrast media. Watersoluble nephrotropic low-osmolar iodinated agents×Calcineurin inhibitor (immunosuppressant)
Updated · Methodology
Mechanism
Contrast (iopromide) and nephrotoxic immunosuppressant (tacrolimus) – high contrast-induced nephropathy risk. The effect is stronger in transplant patients due to already reduced renal function.
Symptoms
Reduced urine output, rising creatinine and potassium, oedema. Symptoms appear earlier in older patients and chronic kidney disease.
Management
For planned contrast studies, provide adequate hydration with saline (1 mL/kg/h for 12 hours before and after). Check tacrolimus trough (C0) 1–3 days after contrast. Alternative imaging: non-gadolinium MRI.
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