Lisinopril and Clonixin: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Lisinopril
Clonixin
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Clonixin is an anti-inflammatory painkiller (an NSAID), and lisinopril is a blood pressure medicine. When taken together, the clonixin can make your lisinopril work a little less well, so your blood pressure may creep up. The bigger concern is that both drugs affect your kidneys, and using them together can put extra strain there, especially if you are older, dehydrated, or already have kidney trouble.
The good news is this is very manageable. Your care team can keep an eye on your blood pressure and check your kidney function, and staying well hydrated helps a lot. Please don't stop either medicine on your own, just talk with your pharmacist or doctor about the best plan.
Interaction: Clonixin (NSAID) may blunt the antihypertensive and natriuretic effect of lisinopril (ACE inhibitor) and can additively impair renal function.
- Mechanism: NSAID inhibition of renal prostaglandin synthesis reduces afferent arteriolar vasodilation; combined with ACE inhibitor efferent effects, this compromises glomerular perfusion and blunts natriuresis.
- Direction: reduced antihypertensive efficacy; risk of renal deterioration, including acute renal failure.
- Evidence: established. Onset: unspecified.
- Management: monitor BP for efficacy; assess renal function at initiation and periodically. Highest risk in elderly, volume-depleted, or preexisting renal impairment. Ensure adequate hydration.
What happens
Reduced antihypertensive effect and renal dysfunction and/or increased blood pressure
Interaction Deep Dive
The natriuretic and blood pressure lowering actions of ACE inhibitors or angiotensin receptor blockers (ARBs) can be reduced by NSAIDs. Combining these agents may also lead to worsening renal function in certain patients, up to and including acute renal failure. If the two must be given together, evaluate whether renal function should be checked when therapy begins, watch for adequate antihypertensive response, and periodically reassess renal function for indications of decline or failure. Such vigilance is particularly important in elderly patients, at the start of treatment, in individuals who are volume-depleted, and in those with existing renal impairment. Confirm that patients maintain adequate hydration1234.
Why it happens (mechanism)
Additive effects on renal function; decreased renal prostaglandin production
How to manage this interaction
If you need both medicines, your care team can manage this safely.
- Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise.
- Your team may check your kidney function when you start and from time to time after that.
- They may monitor your blood pressure to make sure the lisinopril is still working well.
- Stay well hydrated, since dehydration raises the risk to your kidneys.
- Extra caution applies if you are elderly or already have kidney problems.
Tell your pharmacist or prescriber if you notice much less urine, swelling, unusual tiredness, or rising blood pressure readings.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
4 reports — tap to read
a) A 48-year-old man with hypertension that had previously been well managed on enalapril 10 mg/day developed severe hypertension, psychosis, disorientation, and generalized anasarca four days after starting indomethacin 100 mg/day for gout 5. Raising the enalapril dose to 20 mg/day did not bring the hypertension under control, and indomethacin was stopped. One day afterward, the patient underwent rapid diuresis and substantial weight loss. The enalapril dose was subsequently lowered back to 10 mg/day, which achieved good hypertension control with no lingering psychosis 6.
b) In a randomized, double-blind, parallel-design multicenter study of 141 hypertensive patients, indomethacin counteracted the antihypertensive action of captopril. After one week of taking indomethacin together with captopril, 24-hour systolic blood pressure rose by 4.6 mmHg and diastolic by 2.7 mmHg (p less than 0.001). In total, ambulatory diastolic blood pressure increased in 67% of the patients receiving captopril while on indomethacin therapy 7.
c) A 59-year-old man who had been treated with lisinopril 10 mg/day for 5 years experienced worsening hypertension after rofecoxib 25/day was started for arthritic pain. Over 5 weeks, blood pressure rose from 130 to 135/80 to 85 to 168/98. Rofecoxib was stopped. Blood pressure fell over the subsequent 18 days (average, 127/78 mmHg). Rofecoxib was reinitiated at 25 mg/day because of increased joint pain. Following 2 days of treatment, blood pressure rose, and across the next 2 weeks it averaged 143/89 mmHg. Lisinopril was raised to 20 mg/day, yielding an average blood pressure of 121/81 mmHg over the following 21 days 8.
d) In a double-blind, placebo-controlled, parallel-group trial of 178 hypertensive patients, celecoxib did not reduce the antihypertensive effect of lisinopril. For 4 weeks, patients took celecoxib 200 mg twice daily or placebo in addition to their usual lisinopril therapy (10 to 40 mg daily). Changes from baseline in 24-hour systolic and diastolic blood pressure (BP) were nonsignificant. The proportions of patients whose 24-hour BP rose by at least 5, 10, 15, or 20 mmHg were likewise comparable between celecoxib and placebo. The placebo-subtracted changes seen in 24-hour BP (1.6/1.2 mmHg) were smaller than those reported for NSAIDs in patients treated with ACE inhibitors 9.
Common questions
Can I take Lisinopril and Clonixin together?
Taking clonixin with lisinopril can raise your blood pressure and stress your kidneys, so stay hydrated and let your care team monitor your blood pressure and kidney function. Do not stop either medicine on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lisinopril and Clonixin interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Lisinopril and Clonixin interaction managed?
If you need both medicines, your care team can manage this safely. Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise. Your team may check your kidney function when you start and from time to time after that. They may monitor your blood pressure to make sure the lisinopril is still working well. Stay well hydrated, since dehydration raises the risk to your kidneys.… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Lisinopril or Clonixin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (9)
- Product Information: Dynastat intravenous injection, intramuscular injection, parecoxib sodium intravenous injection, intramuscular injection. Pfizer Australia Pty Ltd (per Australian Register of Therapeutic Goods), West Ryde, Australia, 2017. DailyMed
- Product Information: SPRIX(R) nasal spray, ketorolac tromethamine nasal spray. Egalet US Inc. (per FDA), Wayne, PA, 2016. DailyMed
- Product Information: CALDOLOR(R) intravenous injection, ibuprofen intravenous injection. Cumberland Pharmaceuticals Inc. (per FDA), Nashville, TN, 2016. DailyMed
- Product Information: meloxicam oral tablets, meloxicam oral tablets. Apotex Corp. (per DailyMed), Weston, FL, 2016. DailyMed
- Ahmad S: Indomethacin-enalapril interaction: an alert (letter). South Med J 1991; 84:411-412. PubMed
- Morgan T, Anderson A, & Bertram D: Effect of indomethacin on blood pressure in elderly people with essential hypertension well controlled on amlodipine or enalapril. Am J Hypertens 2000; 13:1161-1167. PubMed
- Conlin P, Moore T, Swartz S, et al: Effect of indomethacin on blood pressure lowering by captopril and losartan in hypertensive patients. Hypertension 2000; 36:461-465. PubMed
- Brown C: Effect of rofecoxib on the antihypertensive activity of lisinopril (letter). Ann Pharmacother 2000; 34:1486. PubMed
- White W, Kent J, Taylor A, et al: Effects of celecoxib on ambulatory blood pressure in hypertensive patients on ACE inhibitors. Hypertension 2002; 39:929-934. PubMed
Keep reading about Lisinopril
Keep reading about Clonixin
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