Lisinopril and Dipyrone: 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
Dipyrone
No brand names on recordLisinopril
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.
Dipyrone is a pain and fever medicine that works a bit like other anti-inflammatory drugs (NSAIDs). Lisinopril lowers your blood pressure and helps protect your kidneys. When they are taken together, dipyrone can make lisinopril work less well, so your blood pressure may creep back up. The combination can also put extra strain on your kidneys in some people.
This is more of a concern if you are older, a bit dehydrated, or already have kidney problems. The good news is your care team can manage this by checking your blood pressure and kidney function and keeping you well hydrated. Please don't stop either medicine on your own, just talk with your pharmacist or doctor.
Effect: Dipyrone (an NSAID-type analgesic) may blunt the antihypertensive and natriuretic effect of lisinopril and can additively impair renal function.
Mechanism: Inhibition of renal prostaglandin synthesis reduces afferent arteriolar vasodilation; combined with ACE-inhibitor effects on efferent tone, this lowers GFR and can precipitate acute kidney injury.
- Direction: reduced BP control plus additive renal risk
- Evidence: established (NSAID/ACEi class effect); onset unspecified
- Management: monitor BP for efficacy, assess renal function at initiation and periodically, maintain hydration. Higher risk in elderly, volume-depleted, or preexisting renal dysfunction.
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 diminished by NSAIDs. Concurrent administration may also lead to worsening renal function in certain patients, up to and including acute renal failure. If combined therapy cannot be avoided, evaluate whether renal function monitoring is warranted when treatment begins, watch for adequate antihypertensive response, and periodically check renal function for indications of deteriorating kidney function or failure, particularly among elderly patients, at the start of therapy, in individuals who are volume-depleted, or 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 both are prescribed, keep taking them as directed unless your prescriber tells you otherwise. Your care team can manage this combination well.
- Monitoring: your team may check your blood pressure and kidney function when you start and periodically after.
- Hydration: stay well hydrated, as dehydration raises the risk.
- Extra caution if you are older or have kidney issues.
- Tell your pharmacist or doctor about less urine, swelling, unusual tiredness, or blood pressure that seems higher than usual.
Your doses may be adjusted and individualized by your care team as needed.
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-controlled on enalapril 10 mg/day developed severe hypertension, psychosis, disorientation, and generalized anasarca four days after beginning indomethacin 100 mg/day for gout 5. Increasing the enalapril dose to 20 mg/day did not control the hypertension, so indomethacin was stopped. The following day, the patient underwent rapid diuresis and marked weight loss. The enalapril dose was subsequently lowered to 10 mg/day, achieving 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 effect of captopril. One week of combined indomethacin and captopril therapy raised 24-hour systolic blood pressure by 4.6 mmHg and diastolic by 2.7 mmHg (p less than 0.001). Overall, ambulatory diastolic blood pressure increased in 67% of patients receiving captopril during indomethacin treatment 7.
c) A 59-year-old man who had been treated for 5 years with lisinopril 10 mg/day experienced worsening hypertension after rofecoxib 25/day was started for arthritic pain. Following 5 weeks, blood pressure rose from 130 to 135/80 to 85 up to 168/98. Rofecoxib was stopped. Over the subsequent 18 days, blood pressure fell (average 127/78 mmHg). Because of increased joint pain, rofecoxib was resumed at 25 mg/day. After 2 days of this therapy, blood pressure increased, and over the following 2 weeks it averaged 143/89 mmHg. Lisinopril was raised to 20 mg/day, producing an average blood pressure of 121/81 mmHg over the next 21 days 8.
d) In a double-blind, placebo-controlled, parallel-group trial of 178 hypertensive patients, celecoxib did not diminish the antihypertensive effect of lisinopril. In addition to their usual lisinopril therapy (10 to 40 mg daily), patients received celecoxib 200 mg twice daily or placebo for 4 weeks. Changes from baseline in the 24-hour systolic and diastolic blood pressure (BP) were nonsignificant. The proportion of patients whose 24-hour BP rose by at least 5, 10, 15, or 20 mmHg were likewise similar with celecoxib and placebo. The placebo-subtracted changes seen in 24-hour BP (1.6/1.2 mmHg) were smaller than what has been reported for NSAIDs in ACE inhibitor-treated patients 9.
Common questions
Can I take Lisinopril and Dipyrone together?
Dipyrone can reduce lisinopril's blood pressure benefit and add stress on your kidneys, so keep taking both as prescribed while your care team monitors your blood pressure, kidney function, and hydration. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lisinopril and Dipyrone 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 Dipyrone interaction managed?
If both are prescribed, keep taking them as directed unless your prescriber tells you otherwise. Your care team can manage this combination well. Monitoring: your team may check your blood pressure and kidney function when you start and periodically after. Hydration: stay well hydrated, as dehydration raises the risk. Extra caution if you are older or have kidney issues. Tell your pharmacist or do… 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 Dipyrone 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 Dipyrone
Keep reading about Lisinopril
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