Lisinopril and Droxicam: 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
Droxicam
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.
Lisinopril is a blood pressure medicine (an ACE inhibitor). Droxicam is an anti-inflammatory pain reliever (an NSAID). When you take them together, the NSAID can make your blood pressure medicine work less well, so your blood pressure may creep back up. Both drugs can also affect your kidneys, and using them together adds a little extra strain, especially if you are older, dehydrated, or already have kidney trouble.
The good news is this is very manageable. Don't stop either medicine on your own. Your care team can keep an eye on your blood pressure and kidney function and adjust things if needed. Staying well hydrated helps too.
Effect: Droxicam (NSAID) may blunt the antihypertensive and natriuretic effect of lisinopril (ACE inhibitor) and increase risk of renal deterioration, including acute renal failure.
Mechanism: NSAID inhibition of renal prostaglandin synthesis reduces afferent arteriolar vasodilation; combined with ACE inhibitor efferent vasodilation, this compromises glomerular perfusion. Additive adverse renal effects. Neither agent's activation is relevant here.
- Direction: reduced antihypertensive efficacy; potential renal impairment
- Onset: unspecified; Evidence: established
- Monitoring: BP for efficacy, baseline and periodic renal function/electrolytes
- Higher risk: elderly, volume-depleted, preexisting renal dysfunction, treatment initiation
- Management: ensure adequate hydration; individualize therapy
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. Furthermore, using these agents together may worsen kidney function in certain patients, with acute renal failure being a potential consequence. If the combination cannot be avoided, evaluate whether renal function monitoring is warranted when therapy begins, watch for adequate antihypertensive response, and check renal function at intervals to detect any decline or failure. This is particularly relevant for elderly patients, at the start of treatment, in those who are volume-depleted, and in individuals 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 your care team decides you need both, here is how they typically manage it:
- Keep taking both as prescribed unless your prescriber tells you otherwise.
- Your team may check your kidney function before starting and periodically afterward, especially early on.
- They will watch your blood pressure to make sure it stays controlled.
- Stay well hydrated, which helps protect your kidneys.
- Your doses may be adjusted and individualized by your care team as needed.
Let your pharmacist or doctor know if you feel dizzy, notice swelling, urinate less than usual, or your home blood pressure readings rise.
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 beginning indomethacin 100 mg/day for gout 5. Raising the enalapril dose to 20 mg/day did not control the hypertension, so indomethacin was stopped. Within one day, the patient underwent rapid diuresis and lost a substantial amount of weight. The enalapril dose was subsequently lowered back to 10 mg/day, which achieved good blood pressure control with no lingering psychosis 6.
b) In a randomized, double-blind, parallel-design multicenter study of 141 hypertensive patients, indomethacin counteracted the blood pressure lowering effect of captopril. After one week of combined indomethacin and captopril therapy, 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 patients receiving captopril while on indomethacin 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 during the subsequent 18 days (averaging 127/78 mmHg). Because of worsening joint pain, rofecoxib was resumed at 25 mg/day. After 2 days of this therapy, blood pressure rose, and it averaged 143/89 mmHg over the following 2 weeks. Lisinopril was increased to 20 mg/day, yielding 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. Patients were given either celecoxib 200 mg twice daily or placebo along with their standard lisinopril regimen (10 to 40 mg daily) for 4 weeks. The 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 also 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 Droxicam together?
Taking the NSAID droxicam with lisinopril can raise your blood pressure and stress your kidneys, so keep taking both as prescribed while your care team monitors your blood pressure and kidney function and keeps you hydrated. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lisinopril and Droxicam 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 Droxicam interaction managed?
If your care team decides you need both, here is how they typically manage it: Keep taking both as prescribed unless your prescriber tells you otherwise. Your team may check your kidney function before starting and periodically afterward, especially early on. They will watch your blood pressure to make sure it stays controlled. Stay well hydrated, which helps protect your kidneys. Your doses may b… 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 Droxicam 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 Droxicam
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